Impact of weight bias and stigma on quality of care and outcomes for patients with obesity
Impact of weight bias and stigma on quality of care and outcomes for patients with obesity
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DOI：
10.1111/obr.12266
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发表时间：
2015-04-01
期刊：
影响因子：
8.9
通讯作者：
van Ryn, M.
中科院分区：
文献类型：
--
作者：
Phelan, S. M.;Burgess, D. J.;van Ryn, M.
本研究的目的是严格审查所有相关学科关于肥胖耻辱的经验证据，以便 (i) 确定肥胖耻辱对医疗保健提供者及其肥胖患者的影响，以及 (ii) 确定改善肥胖患者护理的策略。我们在 Medline 和 PsychInfo 上搜索了所有同行评审论文，这些论文提供了与耻辱、偏见、歧视、偏见和医疗保健相关的原始实证数据。然后，我们对有关肥胖耻辱和体重偏见对医疗保健质量和结果影响的现有经验证据进行了叙述性回顾。许多医疗保健提供者对肥胖症患者抱有强烈的负面态度和刻板印象。有大量证据表明，这种态度会影响人的感知、判断、人际行为和决策。这些态度可能会影响他们提供的护理。不良治疗的经历或期望可能会导致肥胖患者产生压力和逃避护理、对医生的不信任以及依从性差。尽管医疗保健提供者本意是提供高质量的护理，但耻辱感会降低肥胖患者的护理质量。有几种潜在的干预策略可以减少肥胖耻辱对护理质量的影响。
The objective of this study was to critically review the empirical evidence from all relevant disciplines regarding obesity stigma in order to (i) determine the implications of obesity stigma for healthcare providers and their patients with obesity and (ii) identify strategies to improve care for patients with obesity. We conducted a search of Medline and PsychInfo for all peer-reviewed papers presenting original empirical data relevant to stigma, bias, discrimination, prejudice and medical care. We then performed a narrative review of the existing empirical evidence regarding the impact of obesity stigma and weight bias for healthcare quality and outcomes. Many healthcare providers hold strong negative attitudes and stereotypes about people with obesity. There is considerable evidence that such attitudes influence person-perceptions, judgment, interpersonal behaviour and decision-making. These attitudes may impact the care they provide. Experiences of or expectations for poor treatment may cause stress and avoidance of care, mistrust of doctors and poor adherence among patients with obesity. Stigma can reduce the quality of care for patients with obesity despite the best intentions of healthcare providers to provide high-quality care. There are several potential intervention strategies that may reduce the impact of obesity stigma on quality of care.