The impact of obesity on primary care visits
The impact of obesity on primary care visits
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DOI：
10.1038/oby.2005.198
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发表时间：
2005-09-01
期刊：
影响因子：
--
通讯作者：
Azari, R
中科院分区：
文献类型：
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作者：
Bertakis, KD;Azari, R
目的：调查患者肥胖对初级保健医生的做法styles.Research方法和程序的影响：这是一个随机的，前瞻性研究的509例患者分配的105个初级保健住院医师的护理。收集的患者数据包括社会人口统计学信息、自我报告的健康状况（医学结局研究简表-36）、抑郁评估（贝克抑郁指数）和满意度。测量身高和体重以计算BMI。访问的录像带进行了分析，使用戴维斯观察代码（DOC）。结果：回归方程估计肥胖相关的访问长度，每个20个单独的DOC代码，和6个DOC医生的实践行为集群，控制患者的健康状况和社会人口。肥胖与访视时间长短没有显著相关性，但会影响访视期间发生的事情。医生花更少的时间教育肥胖患者关于他们的健康（p = 0.0062）和更多的时间讨论运动（p = 0.0075）。肥胖与关于营养的讨论无关。当患者肥胖时，医生在技术任务上花费的时间更长（p = 0.0528）。平均访视前的一般满意度为肥胖患者显着低于非肥胖患者（p = 0.0069），但是，有没有差异，在访视后的患者satisfactions.Discussion：患者肥胖影响的医疗访问。进一步的研究可以促进对肥胖患者和他们的医生之间关系的更好理解。
Objective: To investigate the influence of patient obesity on primary care physician practice style.Research Methods and Procedures: This was a randomized, prospective study of 509 patients assigned for care by 105 primary care resident physicians. Patient data collected included sociodemographic information, self-reported health status (Medical Outcomes Study Short Form-36), evaluation for depression (Beck Depression Index), and satisfaction. Height and weight were measured to calculate the BMI. Videotapes of the visits were analyzed using the Davis Observation Code (DOC).Results: Regression equations were estimated relating obesity to visit length, each of the 20 individual DOC codes, and the six DOC Physician Practice Behavior Clusters, controlling for patient health status and sociodemographics. Obesity was not significantly associated with the length of the visit, but influenced what happened during the visit. Physicians spent less time educating obese patients about their health (p = 0.0062) and more time discussing exercise (p = 0.0075). Obesity was not related to discussions regarding nutrition. Physicians spent a greater portion of the visit on technical tasks when the patient was obese (p = 0.0528). Mean pre-visit general satisfaction for obese patients was significantly lower than for non-obese patients (p = 0.0069); however, there was no difference in post-visit patient satisfaction.Discussion: Patient obesity impacts the medical visit. Further research can promote a greater understanding of the relationships between obese patients and their physicians.