An analysis of directly observed weight communication processes between primary care practitioners and overweight patients

PATIENT EDUCATION AND COUNSELING

卷:102

Article

McHale, Calum T.¹  Cecil, Joanne E.¹  Laidlaw, Anita H.¹ 

[1] Univ St Andrews, Sch Med, Div Populat & Behav Sci, Med & Biol Sci Bldg, St Andrews KY16 9TF, Fife, Scotland

关键词: Overweight;    Obesity;    Direct observation;    Primary healthcare;    Weight management;    Primary care communication;    Weight-related communication;    Communication coding;   

DOI  :  10.1016/j.pec.2019.07.010

来源: Elsevier

【 摘 要 】

Objective: To analyse weight-related communication prevalence and processes (content/context) between primary care practitioners (PCPs) and overweight patients within routine primary healthcare consultations. Methods: Consultations between 14 PCPs and 218 overweight patients (BMI >= 25 kg/m(2)) were video recorded. Weight communication was coded using the Roter Interaction Analysis System (RIAS) and the novel St Andrews Issue Response Analysis System (SAIRAS). Communication code frequencies were analysed. Results: Weight discussion occurred in 25% of consultations with overweight patients; 26% of these had weight-related consultation outcomes (e.g. weight-related counselling and referrals, stated weight-related intention from patients). Weight discussions were more likely to occur if PCPs provided space to patient attempts to discuss weight (p = 0.013). Longer weight discussions (p < 0.001) and contextualising weight as problematic when PCP/patient-initiated weight discussion (p < 0.001) were associated with weight-related consultation outcomes. Conclusion: Weight was rarely discussed with overweight patients, however PCP space provision to patient weight-discussion initiation attempts increased weight discussion. When weight was discussed, increased time and/or contextualising weight as a problem increased the likelihood of weight-related consultation outcomes. Practical implication: PCP use of specific communication approaches when discussing, contextualising and responding to patient weight may facilitate weight-related discussion and consultation outcomes and could lead to more effective patient weight management. (c) 2019 Elsevier B.V. All rights reserved.

【 授权许可】

Free