影响澳大利亚肥胖患者转诊决策的因素分析:一项定性研究

发布时间：2018-09-19 10:22

【摘要】：背景因生活方式和手术干预而推荐患者进行转诊是全科医学临床肥胖管理的一部分。然而,目前的相关实践效果不佳。这一定性研究旨在描述影响全科医生为肥胖患者转诊的因素。方法对澳大利亚新南威尔士州4个地区的24名全科医生进行半结构定性访谈,访谈内容为针对肥胖患者的管理。应用归纳主题分析法进行定性分析。结果影响全科医生转诊决策的首要因素是态度、精力以及患者的积极性。生活方式干预转诊通常是经全科医生建议,受到患者和当地卫生系统的影响。转诊进行肥胖外科手术的要求通常由患者提出,受到医生以往有限经验、患者期待、支付能力和专业法律问题的影响。转诊与地区偏远程度或者手术转诊服务的可及性并无紧密联系。结论全科医生报告的因生活习惯和手术干预而进行转诊的行为存在不同。全科医生的转诊态度通常由以往有限的病例经验而形成,而不是通过更多的系统证据回顾,尤其是手术干预。可针对患者转诊结局,对全科医生进行培养和交流,从而改善这一状况。
[Abstract]:Background referrals due to lifestyle and surgical intervention are part of general-practice obesity management. However, the current practice is not good. The purpose of this study was to describe the factors affecting referrals of obese patients by general practitioners. Methods A semi-structural qualitative interview was conducted among 24 general practitioners in 4 regions of New South Wales, Australia. The interviews were conducted on the management of obese patients. The qualitative analysis is carried out by the method of inductive theme analysis. Results attitude, energy and patient's enthusiasm were the primary factors that influenced the decision of general practitioners. Lifestyle intervention referrals are usually recommended by general practitioners and affected by patients and local health systems. Referrals for obesity surgery are usually made by patients affected by limited experience, patient expectation, affordability, and professional legal issues. Referrals are not closely related to regional remoteness or accessibility of surgical referral services. Conclusion there are differences in the behavior reported by general practitioners for referral due to life habits and surgical intervention. The referral attitude of GP is usually based on the limited case experience, rather than through more systematic evidence review, especially surgical intervention. This condition can be improved by training and communicating with general practitioners according to the outcome of patients' referrals.
【分类号】：R589.2

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