Physicians' attitudes about obesity and their associations with competency and specialty: A cross-sectional study
Physicians' attitudes about obesity and their associations with competency and specialty: A cross-sectional study
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DOI：
10.1186/1472-6963-9-106
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发表时间：
2009-06-24
影响因子：
2.8
通讯作者：
Gillespie, Colleen
中科院分区：
文献类型：
--
作者：
Jay, Melanie;Kalet, Adina;Gillespie, Colleen
背景：医生经常报告对肥胖的消极态度，这被认为会影响病人的护理。然而，人们对治疗肥胖患者的态度是如何形成的却知之甚少。我们对医生进行了一项横断面调查，以更好地表征他们的态度，并探讨态度、肥胖护理的感知能力（包括患者体重减轻的报告）和其他关键医生、培训和实践特征之间的关系。方法：我们调查了一家机构的所有399名内科、儿科和精神科医生的肥胖护理态度、能力，包括医生报告的减肥患者的百分比。我们对态度项进行因子分析，并采用层次回归分析探讨胜任力、报告体重减轻、医生、培训和实践特征对每个态度因素方差的解释程度。结果：总有效率为63%。超过40%的医生对肥胖患者有负面反应，56%的医生认为自己有资格治疗肥胖，46%的医生认为自己在这方面很成功。因子分析显示4个因素：医生不适/偏见、医生成功/自我效能、积极结果预期和消极结果预期。能力和减肥患者的报告百分比与医师成功/自我效能态度因素密切相关。患者评估的技能越高，医生的不适/偏见就越少。培训特征与结果预期相关，新医生报告更积极的治疗预期。与内科教师相比，儿科教师对治疗预期的积极程度更高，精神病学教师的消极程度更低。结论：医师对肥胖的态度与能力、专业和研究生培训年限有关。需要进一步的研究来确定影响的方向，并探讨这些态度对患者护理的影响。
Background: Physicians frequently report negative attitudes about obesity which is thought to affect patient care. However, little is known about how attitudes toward treating obese patients are formed. We conducted a cross-sectional survey of physicians in order to better characterize their attitudes and explore the relationships among attitudes, perceived competency in obesity care, including report of weight loss in patients, and other key physician, training, and practice characteristics.Methods: We surveyed all 399 physicians from internal medicine, pediatrics, and psychiatry specialties at one institution regarding obesity care attitudes, competency, including physician report of percent of their patients who lose weight. We performed a factor analysis on the attitude items and used hierarchical regression analysis to explore the degree to which competency, reported weight loss, physician, training and practice characteristics explained the variance in each attitude factor.Results: The overall response rate was 63%. More than 40% of physicians had a negative reaction towards obese patients, 56% felt qualified to treat obesity, and 46% felt successful in this realm. The factor analysis revealed 4 factors-Physician Discomfort/Bias, Physician Success/Self Efficacy, Positive Outcome Expectancy, and Negative Outcome Expectancy. Competency and reported percent of patients who lose weight were most strongly associated with the Physician Success/Self Efficacy attitude factor. Greater skill in patient assessment was associated with less Physician Discomfort/Bias. Training characteristics were associated with outcome expectancies with newer physicians reporting more positive treatment expectancies. Pediatric faculty was more positive and psychiatry faculty less negative in their treatment expectancies than internal medicine faculty.Conclusion: Physician attitudes towards obesity are associated with competency, specialty, and years since postgraduate training. Further study is necessary to determine the direction of influence and to explore the impact of these attitudes on patient care.