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医患沟通中的程序公平性:超重或肥胖成年人群健康结果的预测因素

Procedural Fairness in Physician-Patient Communication: A Predictor of Health Outcomes in a Cohort of Adults with Overweight or Obesity.

作者信息

Wittleder Sandra, Viglione Clare, Reinelt Tilman, Dixon Alia, Jagmohan Zufarna, Orstad Stephanie L, Beasley Jeannette M, Wang Binhuan, Wylie-Rosett Judith, Jay Melanie

机构信息

Department of Medicine, New York University Grossman School of Medicine, New York, NY, USA.

Herbert Wertheim School of Public Health and Human Longevity Science, UC San Diego, San Diego, CA, USA.

出版信息

Int J Behav Med. 2024 Apr 12. doi: 10.1007/s12529-024-10282-6.

Abstract

BACKGROUND

This study aimed to explore whether patients' perception of procedural fairness in physicians' communication was associated with willingness to follow doctor's recommendations, self-efficacy beliefs, dietary behaviors, and body mass index.

METHODS

This was a secondary analysis of baseline data from 489 primary care patients with a BMI ≥ 25 kg/m (43.6% Black, 40.7% Hispanic/Latino, 55.8% female, mean age = 50 years), who enrolled in a weight management study in two New York City healthcare institutions. We conducted ordinary least squares path analyses with bootstrapping to explore direct and indirect associations among procedural fairness, willingness to follow recommendations, self-efficacy, dietary behaviors, and body mass index, while controlling for age and gender.

RESULTS

Serial, multiple mediator models indicated that higher procedural fairness was associated with an increased willingness to follow recommendations which, in turn, was associated with healthier dietary behaviors and a lower BMI (indirect effect =  - .02, SE = .01; 95% CI [- .04 to - .01]). Additionally, higher procedural fairness was associated with elevated dietary self-efficacy, which was, in turn, was associated with healthier dietary behaviors and lower BMI (indirect effect =  - .01, SE = .003; 95% CI [- .02 to - .002]).

CONCLUSIONS

These findings highlight the importance of incorporating procedural fairness in physician-patient communication concerning weight management in diverse primary care patients.

摘要

背景

本研究旨在探讨患者对医生沟通中程序公平性的认知是否与遵循医生建议的意愿、自我效能信念、饮食行为和体重指数相关。

方法

这是一项对489名体重指数(BMI)≥25kg/m²的初级保健患者的基线数据进行的二次分析(43.6%为黑人,40.7%为西班牙裔/拉丁裔,55.8%为女性,平均年龄 = 50岁),这些患者参加了纽约市两家医疗机构的体重管理研究。我们进行了带自抽样的普通最小二乘路径分析,以探讨程序公平性、遵循建议的意愿、自我效能、饮食行为和体重指数之间的直接和间接关联,同时控制年龄和性别。

结果

系列多重中介模型表明,更高的程序公平性与更高的遵循建议意愿相关,而这又与更健康的饮食行为和更低的BMI相关(间接效应 = -0.02,标准误 = 0.01;95%置信区间[-0.04至-0.01])。此外,更高的程序公平性与更高的饮食自我效能相关,而这又与更健康的饮食行为和更低的BMI相关(间接效应 = -0.01,标准误 = 0.003;95%置信区间[-0.02至-0.002])。

结论

这些发现凸显了在不同初级保健患者的体重管理医患沟通中纳入程序公平性的重要性。

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