基层医疗服务提供者开展儿童肥胖问题对话的观点：一项定性研究。
Primary care providers' perspectives on initiating childhood obesity conversations: a qualitative study.
机构信息
Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA.
Entira Family Clinics, Saint Paul, MN, USA.
出版信息
Fam Pract. 2021 Jul 28;38(4):460-467. doi: 10.1093/fampra/cmaa144.
BACKGROUND
Primary care physicians (PCPs) are in a critical position for identifying, preventing and treating childhood obesity. However, a one-size-fits-all approach does not exist for having conversations about weight with families. A better understanding of how PCPs can address paediatric patients' weight concerns is needed in order to develop effective guidelines and trainings.
OBJECTIVE
To describe PCPs preferences and behaviours regarding weight-related conversations with paediatric patients' and their families.
METHODS
Twenty PCPs affiliated with the University of Minnesota, USA, were recruited to participate in semi-structured interviews. Transcripts were analysed using inductive thematic analysis.
RESULTS
PCP's identified well-child visits as the most appropriate time for weight-related discussions with families. Physicians described what approaches/elements they perceived to work best during conversations: collaboration, empathy, health-focused and objective measures.
CONCLUSIONS
Overall, PCPs were more comfortable with weight-related discussions during annual well-child visits and rarely initiated them during an acute visit or the first encounter with a patient. Objective measures, such as growth charts, were often utilized to start discussions. Considering a large proportion of well-child visits are missed, alternative opportunities to have discussions about healthy lifestyle behaviours should be explored. The integral role PCPs play in paediatric obesity warrants further research.
背景
初级保健医生（PCP）在识别、预防和治疗儿童肥胖方面处于关键地位。然而，对于与家庭进行有关体重的对话，并没有一种一刀切的方法。为了制定有效的指导方针和培训，需要更好地了解 PCP 如何解决儿科患者的体重问题。
目的
描述 PCP 与儿科患者及其家属进行与体重相关的对话时的偏好和行为。
方法
在美国明尼苏达大学的 20 名 PCP 被招募参加半结构化访谈。使用归纳主题分析对转录本进行分析。
结果
PCP 确定常规儿童保健就诊是与家庭进行有关体重讨论的最合适时间。医生描述了他们在对话中认为最有效的方法/元素：协作、同理心、以健康为重点和客观措施。
结论
总体而言，PCP 更愿意在年度常规儿童保健就诊期间进行与体重相关的讨论，很少在急性就诊或首次与患者接触时发起讨论。生长图表等客观措施经常被用来开始讨论。考虑到很大一部分常规儿童保健就诊被错过，应该探索其他讨论健康生活方式行为的机会。PCP 在儿科肥胖中的重要作用需要进一步研究。
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