Department of Healthcare and Emergency Care, South-Eastern Finland University of Applied Sciences, Kotka, 48100, Finland.
Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, 00014, Finland.
BMC Health Serv Res. 2024 Oct 26;24(1):1285. doi: 10.1186/s12913-024-11777-4.
Overweight and obesity are global health concerns, especially significant for older adults at higher risk for chronic diseases. The transition to retirement, altering daily routines, highlights the need for adequate weight management support. Since obesity is a challenging topic in healthcare and socioeconomic inequalities exist in access and utilization, we examined how retired individuals with obesity and low or high education describe their experiences of unmet needs, mismatches, and successes within the healthcare service system for weight management.
This qualitative interview study is part of the Helsinki Health Study. The participants (N = 20, with a body mass index of at least 30 kg/m) were selected from a cohort of retired former employees of the City of Helsinki. Half of the interviewees had low education, and the other half had high education. Women and men were equally represented. The interviews were conducted in 2023 and the data were analyzed using inductive thematic analysis.
Three main themes were formed: Deficiencies in engaged care, Services are mismatched with needs, and Facilitating conditions for individual successes. The first main theme had two sub-themes: Condescending attitude and Ignoring weight during the appointment. The second main theme had one sub-theme: Inadequate personnel resources. The third main theme had one sub-theme: Individual opportunities to acquire information and treatment. Educational differences were most clearly reflected in the sub-themes. Participants with low education more often described experiencing a condescending attitude towards them when seeking care and had had difficulties in obtaining time for appointments due to inadequate resources. Participants with high education described broader experiences related to individual opportunities to acquire information and treatment within the healthcare service system than participants with low education.
The participants in this study highlighted the importance of respectful engagement with the subject of their weight and felt that these kinds of interaction skills should still be developed in healthcare personnel. The participants articulated a need for approaches that are tailored to their unique circumstances. According to the participants, long-term group intervention, provided with peer support and supported by a multidisciplinary team, could sustain their weight management.
超重和肥胖是全球健康关注的问题，尤其是对于慢性病风险较高的老年人而言。退休后的生活转变，日常作息的改变，凸显了对充分的体重管理支持的需求。由于肥胖是医疗保健中的一个具有挑战性的话题，而且在获得和利用方面存在社会经济不平等，因此我们研究了肥胖且受教育程度较低或较高的退休个体如何描述他们在医疗保健服务系统中对体重管理的未满足需求、不匹配和成功的体验。
这是一项赫尔辛基健康研究的定性访谈研究。参与者（N=20，体重指数至少为 30kg/m²）是从赫尔辛基市前雇员队列中选择的。其中一半受访者受教育程度较低，另一半受教育程度较高。男女受访者人数相等。访谈于 2023 年进行，使用归纳主题分析对数据进行分析。
形成了三个主要主题：关注不足的护理、服务与需求不匹配、以及个人成功的促进条件。第一个主要主题有两个子主题：傲慢的态度和忽视预约时的体重。第二个主要主题有一个子主题：人员资源不足。第三个主要主题有一个子主题：个人获取信息和治疗的机会。教育差异在子主题中最为明显地体现出来。受教育程度较低的参与者在寻求护理时更多地描述了他们经历的傲慢态度，并且由于资源不足，他们在预约方面遇到了困难。受教育程度较高的参与者比受教育程度较低的参与者更详细地描述了他们在医疗保健服务系统中获得信息和治疗的个人机会。
本研究的参与者强调了以尊重的态度对待他们体重问题的重要性，并认为这些互动技巧仍需在医疗保健人员中加以培养。参与者提出了对适合其独特情况的方法的需求。根据参与者的说法，长期的小组干预，提供同伴支持并由多学科团队支持，可以维持他们的体重管理。
