School of Primary and Allied Health Care, Monash University Peninsula Campus, Frankston, Victoria, 3199, Australia.
Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Kubang Kerian, Kelantan, Malaysia.
BMC Health Serv Res. 2023 Jul 10;23(1):744. doi: 10.1186/s12913-023-09759-z.
Practitioners' perceptions of patients with obesity and obesity management shape their engagement in obesity care delivery. This study aims to describe practitioners' perceptions, experiences and needs in managing patients with obesity, determine the extent of weight stigma among health practitioners, and identify the factors associated with negative judgment towards patients with obesity.
A cross-sectional online survey was conducted from May to August 2022 with health practitioners commonly involved in obesity management in Peninsular Malaysia, including doctors in primary care, internal medicine and bariatric surgery, and allied health practitioners. The survey explored practitioners' perceptions, barriers and needs in managing obesity, and evaluated weight stigma using the Universal Measures of Bias - Fat (UMB Fat) questionnaire. Multiple linear regression analysis was used to identify demographic and clinical-related factors associated with higher negative judgment towards patients with obesity.
A total of 209 participants completed the survey (completion rate of 55.4%). The majority (n = 196, 94.3%) agreed that obesity is a chronic disease, perceived a responsibility to provide care (n = 176, 84.2%) and were motivated to help patients to lose weight (n = 160, 76.6%). However, only 22% (n = 46) thought their patients were motivated to lose weight. The most frequently reported barriers to obesity discussions were short consultation time, patients' lack of motivation, and having other, more important, concerns to discuss. Practitioners needed support with access to multi-disciplinary care, advanced obesity training, financing, comprehensive obesity management guidelines and access to obesity medications. The mean (SD) of the UMB Fat summary score was 2.99 (0.87), with the mean (SD) domain scores ranging between 2.21 and 4.36 (1.06 to 1.45). No demographic and clinical-related factors were significantly associated with negative judgment from the multiple linear regression analyses.
Practitioners in this study considered obesity a chronic disease. While they had the motivation and capacity to engage in obesity management, physical and social opportunities were the reasons for not discussing obesity with their patients. Practitioners needed more support to enhance their capability and opportunity to engage with obesity management. Weight stigma in healthcare settings in Malaysia should be addressed, given the possibility of hindering weight discussions with patients.
从业者对肥胖症患者和肥胖症管理的看法会影响他们提供肥胖症护理的意愿。本研究旨在描述从业者在管理肥胖症患者方面的看法、经验和需求，确定医疗保健从业者中体重歧视的程度，并确定与对肥胖症患者负面判断相关的因素。
2022 年 5 月至 8 月，对马来西亚半岛常见的参与肥胖症管理的医疗保健从业者（包括初级保健、内科和减重手术医生以及联合健康从业者）进行了横断面在线调查。该调查探讨了从业者在管理肥胖症方面的看法、障碍和需求，并使用通用偏见量表-肥胖（UMB Fat）问卷评估体重歧视。采用多元线性回归分析确定与对肥胖症患者负面判断相关的人口统计学和临床相关因素。
共有 209 名参与者完成了调查（完成率为 55.4%）。大多数参与者（n=196，94.3%）认为肥胖是一种慢性疾病，认为有责任提供治疗（n=176，84.2%），并愿意帮助患者减肥（n=160，76.6%）。然而，只有 22%（n=46）的参与者认为他们的患者有减肥的动力。讨论肥胖症的最常见障碍是咨询时间短、患者缺乏动力以及有其他更重要的问题需要讨论。从业者需要支持获得多学科护理、高级肥胖症培训、资金、综合肥胖症管理指南和肥胖症药物。UMB Fat 总结评分的平均值（标准差）为 2.99（0.87），各领域评分的平均值（标准差）范围在 2.21 至 4.36（1.06 至 1.45）之间。多元线性回归分析未发现与负面判断相关的人口统计学和临床相关因素。
本研究中的从业者认为肥胖是一种慢性疾病。虽然他们有动力和能力参与肥胖症管理，但身体和社会机会是他们没有与患者讨论肥胖症的原因。从业者需要更多的支持来提高他们的能力和机会来参与肥胖症管理。鉴于体重讨论可能会受到阻碍，马来西亚医疗保健环境中的体重歧视问题应予以解决。
