General practitioners' and patients' models of obesity: whose problem is it?
General practitioners' and patients' models of obesity: whose problem is it?
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DOI：
10.1016/s0738-3991(00)00192-0
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发表时间：
2001-09-01
影响因子：
3.5
通讯作者：
Whitehead, MA
中科院分区：
文献类型：
--
作者：
Ogden, J;Bandara, I;Whitehead, MA
初级保健文献强调了在咨询中达成一致和共享模式的重要性。这项研究比较了全科医生和患者的肥胖模型。来自英国各地的89名全科医生(GP)和599名患者完成了关于肥胖的原因、后果和解决方案的调查问卷。在原因方面，结果显示，与普通医生相比，患者更有可能将肥胖归因于腺体/激素问题、新陈代谢缓慢和压力，而普通医生更有可能将肥胖归咎于吃得太多。在后果方面，患者对上班困难的评分更高，而全科医生认为糖尿病更重要。肥胖症的解决方案。这两组人报告了对一系列方法的相似信念，但患者认为全科医生和咨询师更有帮助。全科医生对肥胖者自己的评价更高。有人认为，患者表现出一种自私的肥胖模式，将肥胖归咎于内部不可控因素，但期待外部因素来解决它。相比之下，全科医生通过将原因和解决方案都归因于内部可控因素，展示了一种受害者归咎模式。这种不同的模式对初级保健中可能使用的干预形式有影响，并表明患者更喜欢以专业为基础的方法。GPS更喜欢一种更有耐心的方式。再远一点。结果表明，即使可以通过谈判进行干预，成功率也会很低，因为患者或全科医生的行为将与他们对肥胖本质的看法背道而驰。(C)2001爱思唯尔爱尔兰科学有限公司。保留所有权利。
Primary care literature emphasises the importance of agreement and shared models in the consultation. This study compared general practitioners' (GPs') and patients' models of obesity. Questionnaires concerning beliefs about the causes, consequences and solutions to obesity were completed by 89 general practitioners (GPs) and 599 patients from practices across UK. In terms of causes, the results showed that the patients were more likely to attribute obesity to a gland/hormone problem, slow metabolism and stress than the GPs, whereas the GPs were more likely to blame eating too much. In terms of consequences, the patients rated difficulty getting to work more highly whereas the GPs regarded diabetes as more important. For the solutions to obesity. the two groups reported similar beliefs for a range of methods, but whereas the patients rated the GP and a counsellor as more helpful. the GPs rated the obese person themselves more highly. It is argued that patients show a self serving model of obesity by blaming internal uncontrollable factors for causing obesity yet expecting external factors to solve it. In contrast, GPs show a victim blaming model by attributing both cause and the solution to internal controllable factors. Such differing models have implications regarding the form of intervention likely to be used in primary care and indicate that whereas patients would prefer a more professional based approach. GPs would prefer a more patient-led one. Further. the results suggest that even if an intervention could be negotiated, success rates would be low as either the patient or the GP would be acting in contradiction to their beliefs about the nature of obesity. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.