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医务人员体重偏见:系统评价和荟萃分析。

Weight bias among health care professionals: A systematic review and meta-analysis.

机构信息

School of Population Health, Curtin University, Perth, Western Australia, Australia.

Western Australia Cancer Prevention Research Unit, Curtin University, Perth, Western Australia, Australia.

出版信息

Obesity (Silver Spring). 2021 Nov;29(11):1802-1812. doi: 10.1002/oby.23266. Epub 2021 Sep 6.

Abstract

OBJECTIVE

Weight-biased attitudes and views held by health care professionals can have a negative impact on the patient-provider relationship and the provision of care, but studies have found mixed results about the extent and nature of bias, which warrants a review of the evidence.

METHODS

A systematic review and random-effects meta-analysis were conducted by including studies up to January 12, 2021.

RESULTS

A total of 41 studies met inclusion criteria, with 17 studies providing sufficient data to be meta-analyzed. A moderate pooled effect (standardized mean difference = 0.66; 95% CI: 0.37-0.96) showed that health care professionals demonstrate implicit weight bias. Health care professionals also report explicit weight bias on the Fat Phobia Scale, Antifat Attitudes Scale, and Attitudes Towards Obese Persons Scale. Findings show that medical doctors, nurses, dietitians, psychologists, physiotherapists, occupational therapists, speech pathologists, podiatrists, and exercise physiologists hold implicit and/or explicit weight-biased attitudes toward people with obesity. A total of 27 different outcomes were used to measure weight bias, and the overall quality of evidence was rated as very low.

CONCLUSIONS

Future research needs to adopt more robust research methods to improve the assessment of weight bias and to inform future interventions to address weight bias among health care professionals.

摘要

目的

医疗保健专业人员的体重偏见态度和观点可能会对医患关系和护理服务产生负面影响,但研究发现偏见的程度和性质存在混合结果,因此需要对证据进行审查。

方法

系统回顾和随机效应荟萃分析纳入了截至 2021 年 1 月 12 日的研究。

结果

共有 41 项研究符合纳入标准,其中 17 项研究提供了足够的数据进行荟萃分析。综合效应(标准化均数差=0.66;95%置信区间:0.37-0.96)表明医疗保健专业人员表现出内隐体重偏见。医疗保健专业人员还在肥胖恐惧症量表、反肥胖态度量表和对肥胖者的态度量表上报告了外显体重偏见。研究结果表明,医生、护士、营养师、心理学家、物理治疗师、职业治疗师、言语病理学家、足病医生和运动生理学家对肥胖患者持有内隐和/或外显的体重偏见态度。共有 27 种不同的结果被用来衡量体重偏见,整体证据质量被评为极低。

结论

未来的研究需要采用更强大的研究方法来提高体重偏见的评估,并为医疗保健专业人员中解决体重偏见的未来干预措施提供信息。

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