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A qualitative study of the role of Australian general practitioners in the surgical management of obesity

机译:定性研究澳大利亚的角色全科医生在手术管理肥胖的

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摘要

General practitioners (GPs) are increasingly managing patients with class 2 and 3 obesity (body mass index [BMI] > 35 and 40 kg/m2, respectively). Bariatric surgery is considered for patients with class 2 obesity and comorbidities or class 3 obesity where sustained weight loss using non-surgical interventions has not been achieved. In Australia, GPs facilitate access to surgery through referral processes, but the nature of GP involvement in bariatric pre- and post-surgery care is currently unclear. This qualitative study involved 10 in-depth interviews with GPs and 20 interviews with adults who had all undergone laparoscopic adjustable gastric banding (LAGB) for weight management in Tasmania, Australia. Interviews were transcribed and analysed thematically. Referrals for bariatric surgery commonly occurred at the patient's request or to manage combrbidity. Consistent with previous studies, for GPs, referral patterns were influenced by previous case experience and patients' financial considerations. Accessibility of surgery was also a consideration. Post-surgery, there was a lack of clarity about the role of GPs, with patients generally preferring the surgical team to manage the LAGB. In bariatric surgery, patient preference for surgery, access and comorbidity are key drivers for referral and post-surgical monitoring and support. Greater role clarity and enhanced collaboration between surgeons, GPs and patients following surgery is likely to enhance the experience and outcomes for patients.
机译:全科医生(GPs)越来越多管理类2和3的肥胖患者(身体质量指数(BMI) > 35和40 kg / m2,分别)。2类肥胖和患者肥胖并发症或类3持续使用非手术减肥干预没有实现。通过推荐访问手术过程,但是全科医生参与减肥前的本质和重新护理目前不清楚。定性研究涉及10深度访谈与全球定位系统(GPs)和20的成年人的采访所有经历了腹腔镜可调式胃条带(LAGB)体重管理在塔斯马尼亚,澳大利亚。分析了主题。手术通常发生在病人的请求或管理combrbidity。先前的研究,对GPs、转诊模式受到以前的经验和案例病人的经济因素的考虑。手术也是一个考虑。对象,缺乏清晰的认识全球定位系统(GPs)的作用,患者一般喜欢LAGB手术团队管理。在减肥手术,病人偏好手术,访问和疾病是关键因素推荐和术后监测和支持。外科医生之间的协作、GPs和病人手术后可能会提高对病人的经验和成果。

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