Obesity counseling and guidelines in primary care - A qualitative study
Obesity counseling and guidelines in primary care - A qualitative study
复制标题
DOI：
10.1016/j.amepre.2006.12.008
复制
发表时间：
2007-04-01
影响因子：
5.5
通讯作者：
Crabtree, Benjamin F.
中科院分区：
文献类型：
--
作者：
Leverence, Robert R.;Williams, Robert L.;Crabtree, Benjamin F.
背景：肥胖问题现在在美国很普遍。尽管存在预防和治疗肥胖的临床指南，并且有记录的临床医生对此问题的关注，但初级保健中减少肥胖的咨询很少。本研究的主要目的是调查临床医生对肥胖咨询的看法，并将这些观点与主要肥胖指南的建议进行比较。 方法：在基于实践的研究网络中，对主要为低收入少数族裔人群服务的 20 名临床医生进行了深入访谈和两个焦点小组。使用浸没/结晶和模板方法对数据进行分析。结果：临床医生认为肥胖是一个重要的问题，并报告说，面对有限的患者动机和缺乏支持减肥的资源，他们大多使用简短、有针对性、低强度的咨询。他们认为家庭、文化、社会和社区因素是肥胖问题的核心，而他们自己的努力通常是无效的。这些临床医生同样不相信任何减肥策略的长期有效性。结论：初级保健中的肥胖咨询水平较低可能反映了临床医生对其在该领域无效的自我评估，而不是缺乏兴趣或知识。这些临床医生认为，针对当地社区因素和环境改变的肥胖控制努力是增强他们的努力并将其与成功结果联系起来的关键策略。
Background: The problem of obesity is now epidemic in the United States. Despite the existence of clinical guidelines for prevention and treatment of obesity and documented clinician concern about this problem, counseling for obesity reduction in primary care is infrequent. The principal aim of this study was to examine the views of clinicians on obesity counseling and to compare these views to the recommendations of leading obesity guidelines.Methods: Twenty individual, in-depth interviews and two focus groups of clinicians serving predominantly low-income minority populations were conducted in a practice-based research network. Data were analyzed using immersion/crystallization and template approaches.Results: Clinicians believe obesity is air important problem and report using mostly brief, targeted, low-intensity counseling in the face of limited patient motivation and lack of resources to support weight loss. They view family, cultural, social, and community factors as central to the problem of obesity, and their own efforts as generally ineffective. These clinicians similarly were unconvinced of the long-term effectiveness of any weight-loss strategies.Conclusions: Low levels of obesity counseling in primary care may reflect clinicians' self-assessment of their ineffectiveness in this area rather than lack of interest or knowledge. These clinicians perceive that obesity control efforts aimed at local community factors and environmental modifications are key strategies in augmenting and linking their efforts to successful outcomes.