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有效策略终结医疗保健中的体重歧视。

Effective strategies in ending weight stigma in healthcare.

机构信息

Division of Medicine, University College London, London, UK.

Centre for Obesity Research, University College London, London, UK.

出版信息

Obes Rev. 2022 Oct;23(10):e13494. doi: 10.1111/obr.13494. Epub 2022 Aug 7.

Abstract

Weight stigma impacts negatively healthcare quality and hinders public health goals. The aim of this review was to identify strategies for minimizing weight bias among healthcare professionals and explore future research directions. An electronic search was performed in PubMed, PsycINFO and Scopus (until June 2020). Studies on weight stigma reduction in healthcare students, trainees and professionals were assessed based on specific inclusion and exclusion criteria. A narrative synthesis was undertaken to analyze emerging themes. We identified five stigma reduction strategies in healthcare: (i) increased education, (ii) causal information and controllability, (iii) empathy evoking, (iv) weight-inclusive approach, and (v) mixed methodology. Weight stigma needs to be addressed early on and continuously throughout healthcare education and practice, by teaching the genetic and socioenvironmental determinants of weight, and explicitly discussing the sources, impact and implications of stigma. There is a need to move away from a solely weight-centric approach to healthcare to a health-focused weight-inclusive one. Assessing the effects of weight stigma in epidemiological research is equally important. The ethical argument and evidence base for the need to reduce weight stigma in healthcare and beyond is strong. Although evidence on long-term stigma reduction is emerging, precautionary action is needed.

摘要

体重歧视会对医疗质量产生负面影响,并阻碍公共卫生目标的实现。本综述的目的是确定在医疗保健专业人员中减少体重偏见的策略,并探讨未来的研究方向。我们在 PubMed、PsycINFO 和 Scopus(截至 2020 年 6 月)中进行了电子检索。根据具体的纳入和排除标准,评估了针对医疗保健学生、受训者和专业人员减少体重偏见的研究。我们采用叙述性综合分析方法来分析新出现的主题。我们确定了医疗保健领域的五种减少体重歧视的策略:(i)增加教育,(ii)因果信息和可控性,(iii)引起同理心,(iv)包容体重的方法,以及(v)混合方法。需要通过教授体重的遗传和社会环境决定因素,并明确讨论歧视的来源、影响和影响,在医疗保健教育和实践中尽早并持续解决体重歧视问题。需要从以体重为中心的医疗保健方法转变为以健康为中心的包容体重的方法。评估体重歧视在流行病学研究中的影响同样重要。需要在医疗保健领域乃至更广泛的范围内减少体重歧视的伦理论点和证据基础是强有力的。尽管减少长期歧视的证据正在出现,但需要采取预防措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/063e/9540781/62b376534c82/OBR-23-e13494-g001.jpg

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