Obesity management - Physician practice patterns and patient preference
Obesity management - Physician practice patterns and patient preference
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DOI：
10.1177/0145721706290437
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发表时间：
2006-07-01
影响因子：
3.9
通讯作者：
Wylie-Rosett, Judith
中科院分区：
文献类型：
--
作者：
Davis, Nichola J.;Emerenini, Ada;Wylie-Rosett, Judith
目的本研究的目的是评估市中心诊所患者对减肥咨询的态度，并评估初级保健医生在住院医师培训中的实践行为。方法这是一项横断面调查，连续患者参加门诊内科住院医师连续性诊所在布朗克斯，纽约。参与者完成了一份310项的问卷;一份17项的快速体重、活动和过量筛查（WAVE）;以及13项评估患者对医生在体重管理中作用的态度。进行了图表审查，以确定驻地做法模式。分类数据的关系进行了评估，分析和优势比。结果图表评论（n = 84）表明，80%的患者是肥胖或超重; 21%的肥胖患者和11%的超重患者的诊断记录。在肥胖患者（n = 42）中，17%有营养师推荐，36%有医生减肥建议。一项患者调查显示，86%的肥胖患者希望减肥，64%的人希望营养师推荐，62%的人认为他们的医生可以帮助减肥。肥胖患者比超重患者更容易接受减肥建议。但就诊频率和糖尿病的诊断并没有增加体重得到解决的可能性。结论医生需要解决如何管理肥胖问题，包括评估患者对改变生活方式的态度，并利用营养师和其他转介进行减肥咨询。
Purpose The purpose of this study was to assess inner-city clinic patient attitudes about weight loss counseling and to assess practice behaviors of primary care physicians in residency trainingMethods This is a cross-sectional survey of consecutive patients attending an outpatient internal medicine resident continuity clinic in the Bronx, New York. Participants completed a 310-item questionnaire; a 17-item Quick Weight, Activity & Excess Screener (WAVE); and 13 items to assess patients' attitudes about the physician's role in weight management. A chart review was conducted to ascertain resident practice patterns. Relationships of categorical data were evaluated using, analyses and odds ratios.Results Chart reviews (n = 84) indicated that 80% of patients were either obese or overweight; 21% of obese patients and 11% of overweight patients had the diagnosis documented. Of the obese patients (n = 42) 17% had dietitian referrals and 36% had an indication of physician weight loss recommendation. A patient survey indicated that 86% of obese patients wanted to lose weight, 64% wanted a dietitian referral, and 62% felt that their physician could help with weight loss. Obese patients were significantly more likely to receive weight loss recommendations than were overweight patients. but frequency of visits and the diagnosis of diabetes did not increase the likelihood that weight would be addressed.Conclusions Physicians need to address how to manage obesity including assessing patient attitudes about making lifestyle changes and using dietitian and other referrals for weight reduction counseling.