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联合健康专业人员对生活方式多囊卵巢综合征指南实施的看法:一项定性研究。

Perspectives of Allied Health Professionals on Implementation of the Lifestyle Polycystic Ovary Syndrome Guidelines: A Qualitative Study.

机构信息

Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia.

Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia; School of Nursing, Midwifery & Indigenous Health, Charles Sturt University, Bathurst, NSW, Australia.

出版信息

J Acad Nutr Diet. 2022 Jul;122(7):1305-1316. doi: 10.1016/j.jand.2021.11.013. Epub 2021 Nov 18.

Abstract

BACKGROUND

Polycystic ovary syndrome (PCOS) is a common condition affecting up to 13% of reproductive-aged women. Weight and lifestyle management are key initial treatment strategies for individuals with PCOS, as recommended in international evidence-based guidelines. Allied health professionals, including dietitians, exercise physiologists, and psychologists, are crucial in delivering support for lifestyle and weight management.

OBJECTIVE

Our aim was to explore the barriers and enablers to lifestyle and weight management for individuals with PCOS from the perspectives of allied health professionals.

DESIGN

This was a qualitative study using a phenomenology approach to understand the allied health professionals lived experiences managing the lifestyles of individuals with PCOS. Semi-structured interviews were conducted with allied health professionals (ie, dietitians, exercise physiologists, and psychologist). Interviews were audio-recorded and professionally transcribed. Transcripts were coded inductively and analyzed thematically.

PARTICIPANTS/SETTING: Participants were 15 allied health professionals (ie, 9 dietitians, 5 exercise physiologists, and 1 psychologist) involved in the management of PCOS in Australia (n = 10 in Victoria, n = 5 in other states) and interviewed between June and September 2019.

MAIN OUTCOME MEASURES

Barriers and enablers of allied health professionals relating to the provision of lifestyle and weight management in individuals with PCOS were analyzed.

RESULTS

Barriers relating to individuals with PCOS included insufficient knowledge on lifestyle management; lack of time; socioeconomic disadvantage preventing access to lifestyle support; and psychological issues, such as eating disorders or depression. Barriers relating to health professionals included insufficient knowledge about PCOS and insufficient time during consultation. Barriers relating to the health system included lifestyle recommendations in the PCOS guidelines that are too general and weight-focused, funding system that does not facilitate long-term care, and low integration of care among health professionals.

CONCLUSIONS

Barriers for the individual, health professional, and health system all need to be addressed to improve the implementation of lifestyle management in PCOS care to optimize consistency with the PCOS international evidence-based guidelines.

摘要

背景

多囊卵巢综合征(PCOS)是一种常见病症,影响着多达 13%的育龄妇女。国际循证指南推荐,体重管理和生活方式管理是 PCOS 患者的初始治疗策略。包括营养师、运动生理学家和心理学家在内的医疗保健专业人员在提供生活方式和体重管理支持方面至关重要。

目的

我们旨在从医疗保健专业人员的角度探讨 PCOS 患者进行生活方式和体重管理的障碍和促进因素。

设计

这是一项采用现象学方法的定性研究,旨在了解医疗保健专业人员管理 PCOS 患者生活方式的亲身经历。我们对医疗保健专业人员(即营养师、运动生理学家和心理学家)进行了半结构化访谈。访谈进行了录音,并由专业人员进行了转录。对转录本进行了归纳式编码和主题分析。

参与者/设置:2019 年 6 月至 9 月,我们在澳大利亚(维多利亚州 10 人,其他州 5 人)采访了 15 名参与管理 PCOS 的医疗保健专业人员(即 9 名营养师、5 名运动生理学家和 1 名心理学家)。

主要观察指标

分析与医疗保健专业人员提供 PCOS 患者生活方式和体重管理相关的障碍和促进因素。

结果

与 PCOS 患者相关的障碍包括生活方式管理知识不足;时间不足;社会经济劣势阻碍了获得生活方式支持;以及心理问题,如饮食失调或抑郁。与医疗保健专业人员相关的障碍包括对 PCOS 的了解不足以及咨询期间时间不足。与卫生系统相关的障碍包括 PCOS 指南中关于生活方式的建议过于笼统且以体重为重点、不利于长期护理的资金系统以及卫生专业人员之间护理整合度低。

结论

需要解决个人、医疗保健专业人员和卫生系统的障碍,以改善 PCOS 护理中生活方式管理的实施,使其与 PCOS 国际循证指南更加一致。

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