Čadek Martin, Täuber Susanne, Lawrence Blake J, Flint Stuart W
Carnegie School of Sport, Leeds Beckett University, Leeds, UK.
Faculty of Economics and Business, University of Groningen, Nettelbosje 2, 9712 TS Groningen, Netherlands.
EClinicalMedicine. 2023 Feb 16;57:101855. doi: 10.1016/j.eclinm.2023.101855. eCollection 2023 Mar.
Research has demonstrated that healthcare professionals are not immune to weight stigma attitudes, with evidence showing that people living with overweight or obesity may experience direct and indirect stigma and discrimination. This can impact the quality of care provided and impact patients' engagement in healthcare. Despite this, there is a paucity of research examining patient attitudes towards healthcare professionals living with overweight or obesity, which can also hold implications for the patient-practitioner relationship. Thus, this study examined whether healthcare professionals' weight status impacts patient satisfaction and recalled advice.
In this prospective cohort study, using an experimental design, 237 participants (113 women, 125 men) aged 32 ± 8.92 with a body mass index of 25.87 ± 6.79 kg m were recruited through a participant pooling service (ProlificTM), word of mouth, and social media. The majority of participants were from the UK: 119, followed by participants from the USA: 65, Czechia: 16, Canada: 11, and other countries (N = 26). Participants completed an online experiment consisting of questionnaires assessing satisfaction with healthcare professionals and recalled advice after exposure to one of eight conditions assessing the impact of healthcare professional weight status (lower weight or obesity), gender (woman or man) and profession (psychologist or dietitian). A novel approach to creating the stimuli was used to exposure participants to healthcare professionals of different weight status. All of the participants responded to the experiment hosted on Qualtrics™ in the period from June 8, 2016 to July 5, 2017. Study hypotheses were examined using linear regression with dummy variables and follow up post-hoc analysis to estimate marginal means with adjustment for planned comparisons.
The only statistically significant result was a difference with a small effect in patient satisfaction, where satisfaction was significantly higher in healthcare professional who was a women living with obesity compared to healthcare professional who was a man living with obesity (estimate = -0.30; SE = 0.08; df = 229; ωₚ = 0.05; CI = -0.49 to -0.11; p < 0.001), and healthcare professional who was a women living with lower weight compared to healthcare professional who was a man living with lower weight (estimate = -0.21; SE = 0.08; df = 229; CI = -0.39 to -0.02; ωₚ = 0.02; p = 0.02). There were no statistically significant differences in satisfaction of healthcare professionals and recall of advice in the lower weight compared to obesity conditions.
This study has used novel experimental stimuli to examine weight stigma towards healthcare professionals which is vastly under-researched and holds implications for the patient-practitioner relationship. Our findings showed statistically significant differences and a small effect where satisfaction with healthcare professionals both living with obesity and with a lower weight were higher when the healthcare professional was a woman compared to man. This research should act as a stimulus for further research that aims to examine the impact of healthcare professional gender on patient responses, satisfaction and engagement, and weight stigma from patients towards healthcare professionals.
Sheffield Hallam University.
研究表明，医疗保健专业人员也难以免受体重歧视态度的影响，有证据显示，超重或肥胖者可能会遭受直接和间接的歧视。这可能会影响所提供护理的质量，并影响患者参与医疗保健的程度。尽管如此，针对患者对超重或肥胖的医疗保健专业人员态度的研究却很少，而这也可能对医患关系产生影响。因此，本研究探讨了医疗保健专业人员的体重状况是否会影响患者满意度和所回忆起的建议。
在这项前瞻性队列研究中，采用实验设计，通过参与者汇集服务平台（ProlificTM）、口碑传播和社交媒体招募了237名参与者（113名女性，125名男性），年龄32±8.92岁，体重指数为25.87±6.79kg/m。大多数参与者来自英国：119人，其次是来自美国的参与者：65人，捷克：16人，加拿大：11人，以及其他国家（N=26）。参与者完成了一项在线实验，该实验包括问卷调查，评估对医疗保健专业人员的满意度，并在接触评估医疗保健专业人员体重状况（体重较低或肥胖）、性别（女性或男性）和职业（心理学家或营养师）的八种条件之一后回忆所得到的建议。采用一种新颖的方法来创建刺激因素，以使参与者接触不同体重状况的医疗保健专业人员。所有参与者在2016年6月8日至2017年7月5日期间对Qualtrics™上进行的实验做出了回应。使用带有虚拟变量的线性回归以及后续的事后分析来检验研究假设，以估计边际均值并对计划比较进行调整。
唯一具有统计学意义的结果是患者满意度存在微小差异，与肥胖男性医疗保健专业人员相比，肥胖女性医疗保健专业人员的满意度显著更高（估计值=-0.30；标准误=0.08；自由度=229；ωp=0.05；置信区间=-0.49至-0.11；p<0.001），与体重较低男性医疗保健专业人员相比，体重较低女性医疗保健专业人员的满意度也显著更高（估计值=-0.21；标准误=0.08；自由度=229；置信区间=-0.39至-0.02；ωp=0.02；p=0.02）。与肥胖情况相比，体重较低情况下医疗保健专业人员的满意度和所回忆起的建议没有统计学上的显著差异。
本研究采用了新颖的实验刺激方法来研究对医疗保健专业人员的体重歧视，这方面的研究极为不足，且对医患关系有影响。我们的研究结果显示出统计学上的显著差异，且存在微小影响，即与男性相比，当医疗保健专业人员为女性时，肥胖和体重较低的医疗保健专业人员的患者满意度都更高。这项研究应能刺激进一步的研究，旨在探讨医疗保健专业人员的性别对患者反应、满意度和参与度的影响，以及患者对医疗保健专业人员的体重歧视。
谢菲尔德哈勒姆大学。
