Tasmanian School of Medicine, University of Tasmania, Burnie, TAS 7320, Australia.
Diabetes Centre, Tasmanian Health Service-North West, Burnie, TAS 7320, Australia.
Int J Environ Res Public Health. 2022 Oct 8;19(19):12894. doi: 10.3390/ijerph191912894.
Obesity is common in rural areas, and reduced specialist healthcare access impedes its management. A pilot nurse-practitioner-led Assessment and Management of Obesity and Self-Maintenance (AMOS) Clinic focused on individualised obesity care in people living with type 2 diabetes delivered in a rural setting. This study aimed to explore participant and staff experiences of the multidisciplinary obesity clinic to identify barriers and facilitators to self-care, health, and well-being. A two-stage, mixed-method design was used. Initially, three focus groups involving a sample of AMOS participants and semi-structured staff interviews helped identify key barriers/facilitators. These findings informed a survey delivered to all AMOS participants. Qualitative data were analysed using an inductive two-step thematic networks technique to identify themes. Quantitative data were summarised using descriptive statistics. A total of 54 AMOS participants and 4 staff participated in the study. Four themes were identified to describe AMOS participant experiences': 1. affordability; 2. multidisciplinary care; 3. person-centred care; and 4. motivation. Specialised, multidisciplinary and individualised obesity care available through one clinic facilitated self-care and improved health and well-being. Dedicated multidisciplinary obesity clinics are recommended in rural and remote areas.
肥胖症在农村地区很常见,而专家医疗资源的减少则阻碍了对肥胖症的管理。在农村地区,一项由护士从业者主导的针对 2 型糖尿病患者的肥胖评估和管理(AMOS)诊所的试点项目,专注于提供个体化的肥胖症护理。本研究旨在探讨参与者和工作人员对多学科肥胖症诊所的体验,以确定自我护理、健康和幸福感的障碍和促进因素。采用了两阶段混合方法设计。最初,涉及 AMOS 参与者样本的三个焦点小组和半结构化工作人员访谈有助于确定关键的障碍/促进因素。这些发现为向所有 AMOS 参与者提供的调查提供了信息。定性数据使用归纳式两步主题网络技术进行分析,以确定主题。定量数据使用描述性统计进行总结。共有 54 名 AMOS 参与者和 4 名工作人员参与了这项研究。确定了四个主题来描述 AMOS 参与者的体验:1. 负担能力;2. 多学科护理;3. 以患者为中心的护理;4. 动机。通过一个诊所提供的专业、多学科和个体化的肥胖症护理促进了自我护理,改善了健康和幸福感。建议在农村和偏远地区设立专门的多学科肥胖症诊所。