背景:常识模型提供了一个理解健康信念和行为的框架。它包括由五个领域组成的疾病陈述(身份,cause,后果,时间轴,和控制/固化)。虽然广泛使用,它很少应用于肥胖,但可以解释自我管理决策并为治疗提供信息。这项研究回答了这个问题,什么是患者的疾病代表肥胖?;并检查了常识模型在肥胖背景下的效用。
方法:24名肥胖参与者完成了半结构化电话访谈(12名女性,12名男子)。使用转录本/笔记的定向内容分析来了解五个疾病领域的肥胖疾病表征。评估了性别和种族/民族的潜在差异。
结果:参与者没有使用临床术语来讨论体重。参与者的跨域体验是相互关联的。大多数人将相互作用的生命系统描述为导致体重问题,并使用肥胖的负面影响将其识别为健康威胁。在每个领域都讨论了肥胖的控制/治愈。参与者专注于健康和外观后果(前者对老年人最显著,后者对年轻人最明显)。与体重相关的时间线通常是慢性的。女性更经常描述负面疾病表征和偶发原因(例如,怀孕)。没有按种族/族裔确定的模式。
结论:常识模型在肥胖的背景下是有用的。肥胖疾病表征强调了肥胖及其管理的复杂原因和后果。为了改善与体重相关的护理,研究人员和临床医生应该关注这些与肥胖首选标签相关的信念,肥胖最突出的后果,以及监测变化的方式。
BACKGROUND: The Common Sense Model provides a framework to understand health beliefs and behaviors. It includes illness representations comprised of five domains (identity, cause, consequences, timeline, and control/cure). While widely used, it is rarely applied to obesity, yet could explain self-management decisions and inform treatments. This study answered the question, what are patients\' illness representations of obesity?; and examined the Common Sense Model\'s utility in the context of obesity.
METHODS: Twenty-four participants with obesity completed semi-structured phone interviews (12 women, 12 men). Directed content analysis of transcripts/notes was used to understand obesity illness representations across the five illness domains. Potential differences by gender and race/ethnicity were assessed.
RESULTS: Participants did not use clinical terms to discuss weight. Participants\' experiences across domains were interconnected. Most described interacting life systems as causing weight problems and used negative consequences of obesity to identify it as a health threat. The control/cure of obesity was discussed within every domain. Participants focused on health and appearance consequences (the former most salient to older, the latter most salient to younger adults). Weight-related timelines were generally chronic. Women more often described negative illness representations and episodic causes (e.g., pregnancy). No patterns were identified by race/ethnicity.
CONCLUSIONS: The Common Sense Model is useful in the context of obesity. Obesity illness representations highlighted complex causes and consequences of obesity and its management. To improve weight-related care, researchers and clinicians should focus on these beliefs in relation to preferred labels for obesity, obesity\'s most salient consequences, and ways of monitoring change.