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在现实世界全科医生诊疗中讨论体重:一项录像分析研究。

Discussing Weight in Real World GP Consultations: A Video Recording Analysis Study.

作者信息

Norman Kimberley, Giri Neha, Gunatillaka Nilakshi, West Kellie, Ramachandran Divya, Sturgiss Elizabeth

机构信息

The School of Primary and Allied Health Care Monash University Melbourne Australia.

出版信息

Obes Sci Pract. 2025 Jan 8;11(1):e70034. doi: 10.1002/osp4.70034. eCollection 2025 Feb.

Abstract

OBJECTIVE

GPs have a complex role in obesity management due to patients' individualized experience of living with obesity, coupled with the challenge to deliver healthcare messages in non-stigmatizing ways. This study aimed to explore who initiates the topic of weight and how weight was discussed in real-world GP-patient consultations.

METHOD

A multi-disciplinary team, including obesity lived experience experts, undertook a secondary data analysis of 43 Australian video recorded consultations and patient surveys from The Digital Library using descriptive content analysis.

RESULTS

17/43 consultations included the topic of weight in the discussion. 15 were initiated by the GP and 2 by the patient. 14/17 used a structured approach. All GPs asked for consent to discuss weight or gave patients space to decline the discussion. No overt stigmatizing language was identified. A post-consultation survey found 15/17 patients (2 unanswered) felt listened to and respected during consultations.

CONCLUSION

This study identified the intricate ways GPs approach weight discussions in consultations. GPs navigated weight discussions in ways that made patients feel respected and listened to and related weight to health concerns relevant to each patient.

PRACTICE IMPLICATIONS

The findings in this study can serve as a foundation for establishing education and training resources for GPs and can be utilized as a way of continuing professional development. Any future communication technique resources for GPs should be co-designed with obesity lived experience experts to ensure appropriateness and avoid potential stigma and harm.

摘要

目的

由于患者肥胖的个性化生活体验,以及以无歧视方式传递医疗信息的挑战,全科医生在肥胖管理中扮演着复杂的角色。本研究旨在探讨在现实世界中全科医生与患者的咨询过程中,是谁发起了体重话题以及体重是如何被讨论的。

方法

一个多学科团队,包括有肥胖生活体验的专家,对来自数字图书馆的43次澳大利亚视频记录的咨询和患者调查进行了二次数据分析,采用描述性内容分析方法。

结果

43次咨询中有17次讨论中包含体重话题。15次由全科医生发起,2次由患者发起。17次中有14次采用了结构化方法。所有全科医生都征求了讨论体重的同意,或者给患者拒绝讨论的空间。未发现明显的歧视性语言。咨询后调查发现,17名患者中有15名(2名未回复)表示在咨询过程中感到被倾听和尊重。

结论

本研究确定了全科医生在咨询中处理体重讨论的复杂方式。全科医生以让患者感到被尊重和倾听的方式进行体重讨论,并将体重与每个患者相关的健康问题联系起来。

实践意义

本研究的结果可为全科医生建立教育和培训资源奠定基础,并可作为持续专业发展的一种方式。未来为全科医生提供的任何沟通技巧资源都应与有肥胖生活体验的专家共同设计,以确保适当性,避免潜在的歧视和伤害。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f386/11707803/ee48d77fd125/OSP4-11-e70034-g001.jpg

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