Scottish Collaboration for Public Health Research and Policy, School of Health in Social Science, University of Edinburgh, Edinburgh, UK.
Prim Health Care Res Dev. 2024 Jan 17;25:e5. doi: 10.1017/S1463423623000683.
This qualitative systematic review aimed to synthesise existing qualitative research on HCPs' perceptions and experiences of obesity and its management in primary care settings.
Healthcare professionals (HCPs), particularly those in primary care, play a key role in policy implementation around weight management. Overweight and obese individuals are subject to weight stigma which has negative health consequences and reduces the likelihood of healthcare service usage. An understanding of HCPs' perceptions of obesity and weight management in primary care is necessary for the development and delivery of effective initiatives.
A search strategy developed using the SPIDER framework was applied to Medline and CINAHL databases. Inclusion criteria were applied, and quality assessment was undertaken using the CASP framework. Fifteen papers meeting the inclusion criteria were analysed thematically.
Four themes were identified: conflicting discourses surrounding obesity, medicalisation of obesity, organisational factors, and lack of patient knowledge and motivation. Conflicting discourses around obesity refers to the differing views of HCPs regarding what it means to have and treat obesity. Medicalisation of obesity considers whether obesity should be treated as a medical condition. Organisational factors were identified as knowledge, resources and time that affected HCPs' ability to provide care to overweight or obese. Finally, the review discovered that patients required their own knowledge and motivation to lose weight. This review has highlighted the need to provide safe, non-judgemental spaces for HCPs and patients to discuss weight and weight loss. This is essential to the therapeutic relationship and the provision of effective obesity management.
本定性系统评价旨在综合现有关于初级保健环境中医疗保健专业人员（HCP）对肥胖及其管理的看法和经验的定性研究。
医疗保健专业人员（HCP），特别是初级保健中的专业人员，在体重管理相关政策的实施中发挥着关键作用。超重和肥胖者会受到体重歧视，这会带来负面的健康后果，并降低他们使用医疗保健服务的可能性。了解 HCP 在初级保健中对肥胖和体重管理的看法，对于制定和提供有效的干预措施是必要的。
使用 SPIDER 框架制定的搜索策略应用于 Medline 和 CINAHL 数据库。应用纳入标准，并使用 CASP 框架进行质量评估。分析了符合纳入标准的 15 篇论文的主题。
确定了四个主题：肥胖相关的矛盾话语、肥胖的医学化、组织因素以及患者知识和动机的缺乏。肥胖相关的矛盾话语是指 HCP 对肥胖的含义以及治疗肥胖的看法存在不同观点。肥胖的医学化考虑肥胖是否应被视为一种医学病症。组织因素被确定为影响 HCP 提供超重或肥胖患者护理能力的知识、资源和时间。最后，该综述发现患者需要自己的知识和动机来减肥。本综述强调了为 HCP 和患者提供安全、非评判性的空间来讨论体重和减肥的必要性。这对于治疗关系和有效的肥胖管理至关重要。
