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“有时做出选择不是因为我们有一个选择,而是因为它们是唯一的选择”:农村全科医疗中客户进行体重管理的障碍。

"Sometimes choices are not made, because we have 'a' choice, they're made because they are 'the' choice": Barriers to weight management for clients in rural general practice.

机构信息

University of Waikato, Gate 1, Knighton Road, Hillcrest, Hamilton, New Zealand and Waikato District Health Board, Pembroke Street, Private Bag 3200, 3240, Hamilton, New Zealand.

出版信息

BMC Prim Care. 2022 Oct 25;23(1):268. doi: 10.1186/s12875-022-01874-w.

Abstract

BACKGROUND

Obesity is an international health issue which currently affects over 34% of New Zealand adults and leads to further physical and psychosocial health complications. People living in rural communities experience health inequities and have a high-risk of becoming obese. The aim of this study was to explore and identify barriers to effective weight management in rural Waikato general practice.

METHODS

Using semi-structured interviews, 16 rural Waikato participants shared their experiences with barriers to weight management. Interviews were transcribed and analysed using thematic analysis.

RESULTS

Four themes were identified: resource constraints, rural locality barriers, rural sociocultural norms barriers, and participants' understanding the solutions needed to overcome their specific barriers to effective weight management. For these participants, finding a feasible weight management strategy was a challenging first step in their weight management journey. A programme that would 'work' meant one that was economically viable for low-income persons, accessible, even if living rurally with less resources, and did not cause harm or jeopardise their social connections within family or community.

CONCLUSION

Overall, participants noted a lack of weight management strategy 'choice' because of income, isolation or accessibility of their rural location and/or the sociocultural norms of the community they lived in restricted options available to them. Future weight management initiatives may be better devised from within communities themselves and will need to be cognisant of the barriers specific to rural communities. Rural perspectives have much to offer in any such reconsideration of weight management initiatives.

摘要

背景

肥胖是一个国际性的健康问题,目前影响着超过 34%的新西兰成年人,并导致进一步的身体和心理社会健康并发症。生活在农村社区的人面临健康不平等问题,并且有很高的肥胖风险。本研究旨在探讨和确定怀卡托农村地区普通实践中有效体重管理的障碍。

方法

使用半结构化访谈,16 名怀卡托农村地区的参与者分享了他们在体重管理方面遇到的障碍的经验。访谈记录被转录,并使用主题分析进行分析。

结果

确定了四个主题:资源限制、农村地区障碍、农村社会文化规范障碍、以及参与者对克服其有效体重管理特定障碍所需解决方案的理解。对于这些参与者来说,找到可行的体重管理策略是他们体重管理之旅的一个具有挑战性的第一步。一个“可行”的项目意味着对于低收入人群来说,在经济上可行、可及,即使生活在资源较少的农村地区,并且不会对他们的家庭或社区中的社会关系造成伤害或威胁。

结论

总的来说,参与者注意到由于收入、隔离或他们农村地区的可达性以及他们所在社区的社会文化规范,限制了他们的选择,导致缺乏体重管理策略。未来的体重管理计划可能会更好地在社区内部制定,并且需要意识到农村社区特有的障碍。农村观点在任何此类体重管理计划的重新考虑中都有很大的贡献。

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