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超重和肥胖人群有效体重管理的障碍与促进因素:一项快速综述。

Barriers and enablers to effective weight management for people living with overweight and obesity: A rapid scoping review.

作者信息

Mekonnen Alemayehu, Vasilevski Vidanka, Chapman Anna, Naughton Shaan, Yuen Eva, Willcox Jane, Holmes-Truscott Elizabeth, Ananthapavan Jaithri, Tesfay Fisaha, Sweet Linda, Peeters Anna

机构信息

School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Institute for Health Transformation, Deakin University, Geelong, Australia.

School of Nursing and Midwifery, Centre for Quality and Patient Safety Research-Western Health Partnership, Institute for Health Transformation, Deakin University, Geelong, Australia.

出版信息

Obes Rev. 2025 Mar;26(3):e13858. doi: 10.1111/obr.13858. Epub 2024 Nov 1.

Abstract

A scoping review was conducted to identify barriers and enablers to effective weight management in healthcare settings for people living with overweight and obesity in English-speaking high-income countries. Peer-reviewed and gray literature were systematically searched in June 2024. Data were analyzed using inductive thematic analysis. Of the 15,684 unique articles identified and screened for relevance, 216 studies were included. Healthcare-related barriers and enablers to weight management were organized under three themes: a) healthcare provider-related factors, b) provision of care, and c) policy/funding. Prominent barriers included healthcare provider knowledge deficits and low prioritization of obesity management, mainly in the primary care setting. Weight management beyond the primary care setting was found to be especially challenging, with poor referral pathways, service fragmentation, lack of multidisciplinary practice, and restricted eligibility criteria, hindering the accessibility of services. Developing consistent policies and guidelines, improving the education of healthcare providers, and increasing funding to provide low-cost comprehensive care, were identified as enablers to access and uptake of weight management services. Considerable overlap in the identified barriers existed across healthcare providers and settings. A whole health system approach to minimize barriers and strengthen enablers to weight management services is needed, to address rising obesity rates.

摘要

开展了一项范围综述,以确定英语国家高收入地区医疗环境中超重和肥胖人群有效体重管理的障碍和促进因素。2024年6月系统检索了同行评审文献和灰色文献。采用归纳主题分析法对数据进行分析。在确定并筛选相关性的15684篇独特文章中,纳入了216项研究。与医疗相关的体重管理障碍和促进因素归纳为三个主题:a)医疗服务提供者相关因素;b)护理提供;c)政策/资金。主要障碍包括医疗服务提供者知识欠缺以及肥胖管理优先级低,主要存在于初级保健环境中。研究发现,初级保健以外的体重管理尤其具有挑战性,转诊途径不佳、服务分散、缺乏多学科实践以及资格标准受限,阻碍了服务的可及性。制定统一的政策和指南、改善医疗服务提供者的教育、增加资金以提供低成本的综合护理,被确定为促进体重管理服务可及性和利用率的因素。在医疗服务提供者和环境中,已确定的障碍存在相当大的重叠。需要采取全面的卫生系统方法,以尽量减少障碍并加强体重管理服务的促进因素,以应对不断上升的肥胖率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/193f/11791395/868393f1036a/OBR-26-e13858-g002.jpg

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