对初级保健肥胖患者的态度、行为和策略:一项对德国全科医生的定性访谈研究。

IF 2.3 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL European Journal of General Practice Pub Date : 2021-12-01 DOI:10.1080/13814788.2021.1898582
Julian Wangler, Michael Jansky
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引用次数: 1

摘要

背景:肥胖对医疗保健系统提出了严峻的挑战。全科医生通过诊断和治疗,在预防肥胖方面处于有利地位。零星的研究表明,在初级保健中对肥胖管理的态度可以对成功治疗患者产生重大影响。目的:研究的重点是对肥胖患者的态度和行为模式,提供护理的意愿,方法和策略,以及所经历的挑战。方法:在文献综述的基础上制定访谈指南,于2019年11月至2020年3月对德国北莱茵-威斯特伐利亚州和萨尔州的36名全科医生进行访谈。根据Kluge的定性分类,形成了不同的GPs原型。使用访谈指南的尺寸来推导原型。结果:全科医生被分为四种类型,这取决于他们如何看待自己和他们在治疗病人中的作用。第一种类型(辞职型)对肥胖管理持消极态度,缺乏提供护理的意愿。第二种类型(指导员)强调积极锻炼、饮食和促进健康的价值,而第三种类型(激励者)认为心理社会支持和激励是帮助患者的关键因素。相比之下,第四种类型(教育者)主要侧重于通过患者教育进行早期预防。结论:肥胖管理和医患沟通的重点和策略应根据患者就诊类型的不同而不同。这导致对治疗措施的不同观点和成功机会。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Attitudes, behaviours and strategies towards obesity patients in primary care: A qualitative interview study with general practitioners in Germany.

Background: Obesity poses severe challenges for the health care system. GPs are in an advantageous position to contribute to preventing obesity by diagnosing patients and initiating treatment. Sporadic studies have shown that attitudes towards obesity management in primary care can have a major influence on treating patients successfully.

Objectives: The study focuses on attitudes and behavioural patterns towards obesity patients, willingness to provide care, approaches and strategies, and the challenges experienced.

Methods: After developing the interview guides based on a literature review, 36 GPs in North Rhine-Westphalia and Saarland, Germany, were interviewed between November 2019 and March 2020. Using qualitative typing according to Kluge, different prototypes of GPs were formed. The dimensions of the interview guides were used for deriving the prototypes.

Results: GPs were categorised into four types depending on how they saw themselves and their role in treating patients. The first type (the resigned) was conspicuous through its negative attitude towards obesity management and a lack of willingness to provide care. The second type (the instructors) emphasised the value of active exercise, diet and health promotion, while the third type (the motivators) saw psychosocial support and motivation as a key element in helping patients. In contrast, type four (the educators) focussed primarily on early prevention through patient education.

Conclusion: Depending on which (proto-)type a patient visits, different focuses and strategies are pursued for obesity management and doctor-patient communication. This results in different perspectives and chances of success about therapeutic measures.

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来源期刊
European Journal of General Practice
European Journal of General Practice PRIMARY HEALTH CARE-MEDICINE, GENERAL & INTERNAL
CiteScore
5.10
自引率
5.90%
发文量
31
审稿时长
>12 weeks
期刊介绍: The EJGP aims to: foster scientific research in primary care medicine (family medicine, general practice) in Europe stimulate education and debate, relevant for the development of primary care medicine in Europe. Scope The EJGP publishes original research papers, review articles and clinical case reports on all aspects of primary care medicine (family medicine, general practice), providing new knowledge on medical decision-making, healthcare delivery, medical education, and research methodology. Areas covered include primary care epidemiology, prevention, diagnosis, pharmacotherapy, non-drug interventions, multi- and comorbidity, palliative care, shared decision making, inter-professional collaboration, quality and safety, training and teaching, and quantitative and qualitative research methods.
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