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一项针对肥胖症患者体重耻辱感的患者教育计划对其生活质量和自我效能的影响:一项随机对照试验的研究方案

Effect of a patient education program focused on weight stigma on quality of life and self-efficacy in patients living with obesity: study protocol for a randomized controlled trial.

作者信息

Ramsamy Guillaume, Esnard Catherine, Mosbah Helena, Soussi Berjonval David, Faure Jean Pierre, Albouy Marion

机构信息

University of Poitiers, CNRS, UMR7295 Research Center On Cognition and Learning (CeRCA), Poitiers, France.

Specialized Obesity Center, University Hospital Center of Poitiers, Poitiers, France.

出版信息

BMC Psychol. 2024 Dec 18;12(1):734. doi: 10.1186/s40359-024-02274-8.

Abstract

BACKGROUND

After a literature review and interviews with patients living with obesity, key psychosocial determinants such as coping strategies, weight bias internalization, body dissatisfaction and self-efficacy were identified as critical to address obesity-related stigma. The intervention was tailored using evidence-based techniques and input from health professionals to ensure relevance and avoid redundancy. This randomized controlled trial (RCT) aims to evaluate the effect of an intervention specifically designed to address weight stigma among individuals living with obesity.

METHODS

The study compares two parallel arms following different interventions: Patient Education as Usual (PEU) program and the newly developed Patient Education STEREOBES (PES) program, which integrates additional components to counteract weight stigma. The PES program, crafted using the Intervention Mapping process, addresses key psychosocial determinants such as self-efficacy, body image, and coping strategies. It incorporates workshops focused on psychoeducation, physical activity, and emotional regulation through innovative techniques like mindfulness, assertiveness training, and Acceptance and Commitment Therapy (ACT). The program emphasizes group activities and patient interaction to foster resilience against stigmatizing experiences and promote healthier lifestyle choices. This comprehensive intervention is designed to improve psychological, behavioral, and physical outcomes, particularly by reducing the internalization of weight bias and enhancing coping mechanisms.

DISCUSSION

Patients in the PES arm should demonstrate significant improvements in quality of life and self-efficacy compared to the PEU arm. Psychosocial factors should mediate the effect of the intervention on the outcomes involving quality of life and behaviors. This study will provide valuable insights into the role of weight stigma in obesity treatment and the effectiveness of targeted interventions.

TRIAL REGISTRATION

This research protocol has been approved by the Individual Protection Committee Northwest IV (National n°2023-A00327-38) and registered on Clinicaltrial.gov (NCT05906238) on June 7, 2023.

摘要

背景

在对文献进行综述并与肥胖症患者进行访谈后,确定了应对策略、体重偏见内化、身体不满和自我效能感等关键心理社会决定因素对于解决肥胖相关耻辱感至关重要。该干预措施采用循证技术并结合健康专业人员的意见进行量身定制,以确保相关性并避免冗余。这项随机对照试验(RCT)旨在评估一项专门设计用于解决肥胖症患者体重耻辱感的干预措施的效果。

方法

该研究比较了接受不同干预措施的两个平行组:常规患者教育(PEU)计划和新开发的患者教育STEREOBES(PES)计划,后者整合了额外的组成部分以对抗体重耻辱感。PES计划采用干预映射流程制定,解决了自我效能感、身体形象和应对策略等关键心理社会决定因素。它通过正念、自信训练和接纳与承诺疗法(ACT)等创新技术,纳入了侧重于心理教育、体育活动和情绪调节的工作坊。该计划强调小组活动和患者互动,以增强对耻辱经历的恢复力并促进更健康的生活方式选择。这项全面的干预措施旨在改善心理、行为和身体方面的结果,特别是通过减少体重偏见的内化和增强应对机制。

讨论

与PEU组相比,PES组的患者在生活质量和自我效能感方面应表现出显著改善。心理社会因素应介导干预措施对涉及生活质量和行为的结果的影响。这项研究将为体重耻辱感在肥胖症治疗中的作用以及针对性干预措施的有效性提供有价值的见解。

试验注册

本研究方案已获得西北四区个人保护委员会(国家编号2023 - A00327 - 38)的批准,并于2023年6月7日在Clinicaltrial.gov(NCT05906238)上注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d920/11658253/a2363527a2ac/40359_2024_2274_Fig1_HTML.jpg

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