Department of General, Gastroenterological, and Oncological Surgery Collegium Medicum, Nicolaus Copernicus University, Torun, Poland.
Department of Sociology of Medicine and Social Pathology, Medical University of Gdansk, Gdansk, Poland.
Obes Facts. 2023;16(3):216-223. doi: 10.1159/000529266. Epub 2023 Feb 1.
Proper diagnosis of obesity, its severity, and complications and their effective treatment requires an interdisciplinary healthcare approach. Nevertheless, obesity remains under-identified and undertreated. Academic knowledge concerning obesity pathology, diagnosis, and treatment is advancing. It is not clear whether this translates into clinical practice. The goal of the study was to assess the knowledge of healthcare professionals (HCPs) on obesity and particularly on the criteria for diagnosis as well as for conservative and surgical treatment.
This cross-sectional study was conducted among active HCPs (N = 184), including physicians, nurses, physiotherapists, and paramedics who had contact with adult patients with obesity. The proprietary research survey, implemented in an online tool, was used to assess knowledge on the diagnosis and treatment of obesity and self-assessment of that knowledge. The analysis was limited to the following: body mass index (BMI) definition, BMI values, visceral obesity definition, bariatric surgery indications, choice of treatment method, role of diet and physical activity, knowledge of obesity pharmacotherapy, length of obesity pharmacotherapy, financing of bariatric procedures, and goals of bariatric treatment. The correct answers were determined according to the Polish guidelines for the diagnosis and treatment of obesity.
Half of the respondents (52.2%) were doctors, 20.7% were nurses and midwives, 19.0% were physiotherapists, and 8.2% were other medical professionals. Among questions related to knowledge on obesity, 67.1% of respondents provided correct answers, with respondents answering questions concerning obesity diagnosis correctly more frequently (70.1%) than those concerning methods of treatment (64.6%). The largest number of correct answers was related to the definition of BMI and normal BMI values. The smallest number of correct answers pertained to the diagnostic criteria for visceral obesity and pharmacological treatment of obesity. There was no statistically significant impact of a responder's knowledge levels on the obesity of different HCPs. Workplace and participation in training sessions were found to have the largest impact on the level of knowledge on obesity. HCPs' own assessment of their knowledge on obesity was negatively correlated with their actual level of knowledge.
The prevalence of overweight and obesity implies that essentially every HCP has daily contact with patients with excessive body weight. Knowledge of BMI values cannot be considered as exclusively medical knowledge: these values were established years ago and are present in widely available sources. Our research showed that 32.9% of HCPs did not have sufficient knowledge about how to diagnose and treat obesity.
正确诊断肥胖症及其严重程度和并发症，并进行有效治疗，需要采取跨学科的医疗保健方法。然而，肥胖症的诊断和治疗仍未得到充分重视。有关肥胖症病理、诊断和治疗的学术知识正在不断发展。目前尚不清楚这些知识是否已经转化为临床实践。本研究的目的是评估医疗保健专业人员（HCP）对肥胖症的认识，特别是对诊断标准以及保守和手术治疗的认识。
这是一项横断面研究，对象为 184 名活跃的 HCP，包括与肥胖成年患者有接触的医生、护士、物理治疗师和辅助医疗人员。采用在线工具实施的专有研究调查评估了肥胖症的诊断和治疗知识以及对这些知识的自我评估。分析仅限于以下内容：体重指数（BMI）定义、BMI 值、内脏肥胖定义、减重手术适应证、治疗方法的选择、饮食和体育活动的作用、肥胖症药物治疗知识、肥胖症药物治疗的持续时间、减重手术的融资以及减重治疗的目标。正确答案是根据波兰肥胖症诊断和治疗指南确定的。
受访者中有一半（52.2%）是医生，20.7%是护士和助产士，19.0%是物理治疗师，8.2%是其他医疗专业人员。在与肥胖症知识相关的问题中，67.1%的受访者给出了正确答案，他们回答肥胖症诊断相关问题的正确率（70.1%）高于治疗方法相关问题（64.6%）。回答最多的是关于 BMI 的定义和正常 BMI 值的问题。回答最少的是内脏肥胖症的诊断标准和肥胖症的药物治疗。不同 HCP 的肥胖症知识水平对回答正确率没有统计学意义的影响。工作场所和参加培训课程对肥胖症知识水平的影响最大。HCP 对自己肥胖症知识的评估与他们实际的知识水平呈负相关。
超重和肥胖症的普遍存在意味着几乎每个 HCP 每天都与体重超标的患者接触。BMI 值的知识不能仅被视为医学知识：这些值是多年前确定的，并且存在于广泛可用的来源中。我们的研究表明，32.9%的 HCP 对如何诊断和治疗肥胖症的知识掌握不足。
