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肥胖患者在医疗保健环境中感知到的体重歧视:横断面调查患者特征和以患者为中心的护理与体重歧视的关系。

Perceived weight stigma in healthcare settings among adults living with obesity: A cross-sectional investigation of the relationship with patient characteristics and person-centred care.

机构信息

Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.

Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.

出版信息

Health Expect. 2024 Feb;27(1):e13954. doi: 10.1111/hex.13954.

Abstract

INTRODUCTION

Patients living with obesity often experience weight stigma in healthcare settings, which has worrying consequences for their healthcare experiences. This cross-sectional study aimed to: (1) provide an overview of stigmatising experiences in healthcare settings reported by adults living with varying classes of obesity, (2) identify associations among patient characteristics and perceived weight stigma and (3) investigate the association between perceived weight stigma and person-centred care (PCC).

METHODS

Dutch adults living with obesity classes I (body mass index [BMI]: 30 to <35 kg/m; n = 426), II (BMI: 35 to <40 kg/m; n = 124) and III (BMI: ≥40 kg/m; n = 40) completed measures of perceived weight stigma in healthcare settings and PCC. Descriptive, correlational and multivariate analyses were conducted.

RESULTS

Of patients living with classes I, II and III obesity, 41%, 59% and 80%, respectively reported experiences of weight stigma in healthcare settings. Younger age, greater obesity severity and the presence of chronic illnesses were associated with greater perceived weight stigma. Greater perceived weight stigma was associated with lower PCC.

CONCLUSION

The results of this study emphasise the significant role of weight stigma in the healthcare experiences of patients living with obesity. Reducing weight stigma is expected to improve PCC and the overall quality of care for these patients. Minimising weight stigma will require efforts across various healthcare domains, including increasing awareness among healthcare professionals about sensitive communication in weight-related discussions.

PATIENT CONTRIBUTION

Our sample consisted of patients living with obesity. Additionally, patients were involved in the pilot testing and refinement of the PCC instrument.

摘要

简介

肥胖患者在医疗保健环境中经常经历体重歧视,这对他们的医疗保健体验产生了令人担忧的后果。本横断面研究旨在:(1)概述不同肥胖程度的成年人在医疗保健环境中报告的歧视经历;(2)确定患者特征与感知体重歧视之间的关联;(3)调查感知体重歧视与以患者为中心的护理(PCC)之间的关联。

方法

荷兰肥胖 I 级(BMI:30 至<35kg/m;n=426)、II 级(BMI:35 至<40kg/m;n=124)和 III 级(BMI:≥40kg/m;n=40)的成年人完成了医疗保健环境中感知体重歧视和 PCC 的测量。进行了描述性、相关性和多变量分析。

结果

分别有 41%、59%和 80%的肥胖 I 级、II 级和 III 级患者报告在医疗保健环境中经历过体重歧视。年龄较小、肥胖程度较重和患有慢性疾病与感知体重歧视程度较高相关。感知体重歧视程度越高,PCC 越低。

结论

本研究结果强调了体重歧视在肥胖患者医疗保健体验中的重要作用。减少体重歧视有望改善这些患者的 PCC 和整体护理质量。减少体重歧视将需要在各个医疗保健领域做出努力,包括提高医疗保健专业人员在体重相关讨论中进行敏感沟通的意识。

患者贡献

我们的样本包括肥胖患者。此外,患者还参与了 PCC 工具的试点测试和改进。

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