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Talking about overweight and obesity in rural Australian general practice

机译:浅谈农村澳大利亚一般实践中的超重和肥胖

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Abstract As many patients’ sole point of contact with the health care system, primary health care physicians (general practitioners [GPs] in Australia) are often positioned as key players in responding to rates of overweight and obesity in dominant public discourse. However, research from Western industrialised countries suggests that GPs may not be prepared for, or confident in, having conversations about overweight and obesity with patients. Little attention has been given to this topic in Australia, particularly in the context of rural health. The aim of this study was to understand how GPs in two rural settings in Victoria, Australia talk about overweight and obesity with patients. Working from a multidisciplinary perspective, a qualitative study design was adopted, and semi‐structured interviews were conducted with seven GPs and seven GP patients living in two rural communities between January and April, 2016. Data was coded manually and thematic analysis was used to explore the data. The findings of this study support the argument that, in contrast to dominant messages within public health discourses, GPs may not be best placed to act as the primary actors in responding to overweight and obesity as they are constructed in epidemiological terms. In fact, the perspectives of GP study participants suggest that to do so would compromise important dimensions of general medical practice that make it simultaneously a human practice. Instead, more balanced, holistic approaches to discussing and responding to overweight and obesity with patients could be taken up in local, interdisciplinary collaborations between different health professionals and patients, which utilise broader social supports. Focussing on long‐term, incremental programs that consider the whole person within their particular socio‐cultural environment would be a productive means of working with the complexities of overweight and obesity. However, structural level changes are required to ensure such initiatives are sustainable in rural practice.
机译:摘要与卫生保健系统的许多患者唯一的接触点,初级保健医师(澳大利亚的全科医生[GPS])通常被定位为关键参与者,以应对主导公众话语的超重和肥胖率。然而,来自西方工业化国家的研究表明,GPS可能无法为与患者进行超重和肥胖的对话。在澳大利亚的这一主题上,特别是在农村健康的背景下,已经提出了很少的关注。本研究的目的是了解维多利亚州两国农村环境中的GPS如何与患者谈论超重和肥胖。从多学科的角度工作,采用了一个定性的研究设计,并在2016年1月至4月期间,七个GPS和七个GP患者进行了半结构性访谈。通过手动编码数据,使用专题分析来探索数据数据。本研究的调查结果支持争论,与公共卫生话语中的主导信息相比,GPS可能无法作为主要参与者在回应超重和肥胖时,因为它们以流行病学术语构建。事实上,GP学习参与者的观点表明,这样做会损害一般医疗实践的重要方面,使其同时成为人类实践。相反,在不同的健康专业人士和患者之间的地方,可以在利用更广泛的社会支持的地方讨论和响应患者的讨论和响应超重和肥胖的讨论和响应超重和肥胖的方法。关注长期的渐进计划,以考虑他们特定的社会文化环境中的全人们将是与超重和肥胖的复杂性合作的富有成效手段。然而,需要结构级别变更,以确保此类举措是在农村惯例中可持续的。

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