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12 result(s) for "Birney, Susie"
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‘Beyond the Scale’: A Qualitative Exploration of the Impact of Weight Stigma Experienced by Patients With Obesity in General Practice
Objective Obesity is a complex, chronic, relapsing disease that requires an individualised approach to treatment. However, weight stigma (WS) experienced in healthcare settings poses a significant barrier to achieving person‐centred care for obesity. Understanding the experiences of people living with obesity (PwO) can inform interventions to reduce WS and optimise patient outcomes. This study explores how patients with obesity perceive WS in general practice settings; its impact on their psychological well‐being and health behaviours, and the patients suggestions for mitigating it. Methods In‐depth semistructured interviews were conducted with 11 PwO who had experienced WS in general practice settings in Ireland. The interviews were conducted online via Zoom between May and August 2023; interviews lasted between 31 and 63 min (M = 34.36 min). Interviews were audio‐recorded, transcribed verbatim and analysed using inductive reflexive thematic analysis. Results Three overarching themes specific to participants' experience of WS in general practice were generated: (1) shame, blame and ‘failure’; (2) eat less, move more—the go‐to treatment; (3) worthiness tied to compliance. A fourth theme: (4) the desire for a considered approach, outlines the participants' suggestions for reducing WS by improving the quality of patient–provider interactions in general practice. Conclusion The findings call for a paradigm shift in the management of obesity in general practice: emphasising training for GPs in weight‐sensitive communication and promoting respectful, collaborative, and individualised care to reduce WS and improve outcomes for people with obesity. Patient or Public Contribution PPI collaborators played an active and equal role in shaping the research, contributing to the development of the research questions, refining the interview schedule, identifying key themes in the data, and granting final approval to the submitted and published version of the study.
The experiences of people living with obesity and chronic pain: A Qualitative Evidence Synthesis (QES) protocol
There is a substantial and progressive association between chronic pain (CP) and living with overweight or obesity. The relationship between obesity and CP is intricate and complex, with obesity being associated with increased pain-related disability, pain intensity, reduction in physical functioning and poorer psychological well-being. A Qualitative Evidence Synthesis (QES) provides an opportunity to better understand and reveal key areas within the patient experience of these complex interactions to inform best practice and future intervention design. The aim of this QES is to methodically and systematically review and synthesise the qualitative literature reporting on the personal experiences of people who are both living with obesity (PwO) and chronic pain. The phenomenon of interest of this QES is the lived experiences of PwO and CP. The following research question was developed using a modified Population, Intervention, Comparison, Outcome and Study type (PICOS) framework: \"What are the lived experiences of people living with obesity and chronic pain?\". One review author will conduct a systematic search based on keywords and Medical Subject Headings (MeSH) terms for finding relevant articles in five peer-review databases, from inception to the date of searching. Two review authors will independently apply inclusion and exclusion criteria and screen articles in a two-stage process. The methodological quality of included studies will be assessed using the Critical Appraisal Skills Programme (CASP) tool and data will be extracted using a customised template. We will undertake a thematic synthesis of qualitative data from included studies and report our findings narratively. Confidence in the findings will be assessed based on the Grading of Recommendations Assessment, Development and Evaluation Confidence in Evidence from Reviews of Qualitative Research (GRADE-CER-Qual) approach. This study will follow the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA) and Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guidelines. It is anticipated that the findings of the review will facilitate a deep and broad understanding of the complex interactions between CP and obesity and will help inform best practice and future intervention design. Findings will be disseminated through journals that undergo peer review, presentations at conferences, engagement with public and patient advocacy groups, and social media. Ethical approval is not required to conduct this review. PROSPERO registration number: CRD42023361391.
Obesity in Adults: A 2022 Adapted Clinical Practice Guideline for Ireland
Background: This Clinical Practice Guideline (CPG) for the management of obesity in adults in Ireland, adapted from the Canadian CPG, defines obesity as a complex chronic disease characterised by excess or dysfunctional adiposity that impairs health. The guideline reflects substantial advances in the understanding of the determinants, pathophysiology, assessment, and treatment of obesity. Summary: It shifts the focus of obesity management toward improving patient-centred health outcomes, functional outcomes, and social and economic participation, rather than weight loss alone. It gives recommendations for care that are underpinned by evidence-based principles of chronic disease management; validate patients’ lived experiences; move beyond simplistic approaches of “eat less, move more” and address the root drivers of obesity. Key Messages: People living with obesity face substantial bias and stigma, which contribute to increased morbidity and mortality independent of body weight. Education is needed for all healthcare professionals in Ireland to address the gap in skills, increase knowledge of evidence-based practice, and eliminate bias and stigma in healthcare settings. We call for people living with obesity in Ireland to have access to evidence-informed care, including medical, medical nutrition therapy, physical activity and physical rehabilitation interventions, psychological interventions, pharmacotherapy, and bariatric surgery. This can be best achieved by resourcing and fully implementing the Model of Care for the Management of Adult Overweight and Obesity. To address health inequalities, we also call for the inclusion of obesity in the Structured Chronic Disease Management Programme and for pharmacotherapy reimbursement, to ensure equal access to treatment based on health-need rather than ability to pay.
How do people living with obesity who use obesity services perceive healthcare professionals’ representation of the disease on social media? An interpretative phenomenological analysis
ObjectivesThe objective of this study was to explore how people living with obesity who use obesity services perceive healthcare professionals’ (HCPs) online representation of the disease on social media. By exploring their perspective, we aimed to develop a framework to inform good practice around social media use for HCPs.DesignThis was a qualitative study using a phenomenological framework. Following in-depth semi-structured interviews, analysis was undertaken to identify superordinate themes relating to how HCPs portray living with obesity online.SettingPatient advocacy organisation (The Irish Coalition for People Living with Obesity) and three clinical sites offering obesity treatment in Ireland.Participants15 adult participants comprising of 12 women and 3 men who use social media and are living with obesity and who use obesity services.ResultsThree key themes of how people living with obesity who use obesity services perceive HCP’s online representation of the disease. (1) Negative experiences of HCPs—participants describe encountering weight stigma and bias on social media from HCPs that they characterised as simplistic and outdated conceptualisations. These engender shame, fear and anger. (2) Positive experience of HCPs—participants report social media allows HCPs to educate and inform public perception of obesity. Positive online experiences lead to feelings of inclusion, understanding and encouragement. (3) Expectations of HCPs—qualifications, professional titles and academic association affected the perceived trustworthiness of information and its impact on readers. Participants feel there is a duty of care for HCPs in obesity medicine to advocate and be active online to provide accurate medical information.ConclusionHCP’s use of social media has a powerful impact on people with obesity who use healthcare and obesity services. Social media is a key tool in obesity awareness and education. We propose the ‘3E’ framework—Empower, Evidence-Based and Educate and be educated to guide HCPs’ social media use.
Factors that influence general practitioners' obesity‐related clinical practices and determinants of behavior to target to promote best practice in obesity care: A qualitative exploration
Introduction General practitioners (GPs) have been identified as pivotal in the identification and initiation of treatment for obesity, yet effective obesity management remains challenging in general practice. Despite the growing prevalence of obesity and the central role of GPs, there is a dearth of research exploring their experiences and challenges in managing the disease. Objective This study aimed to understand these challenges by exploring GPs' experiences and to identify factors influencing their obesity management practices to inform the development of targeted intervention strategies. Method In‐depth interviews were conducted with 10 GPs. Data were analyzed using abductive thematic analysis underpinned by the theoretical domains framework (TDF). Findings were mapped to the behavior change wheel (BCW) and the behavior change taxonomy to identify potential future intervention strategies. Findings Participants described multiple barriers to effective obesity management, including knowledge gaps, lack of training, patient factors, and systemic challenges. Key themes identified were the need for increased support, improved patient engagement, and system‐level changes. Conclusion This study offers valuable insights into the challenges GPs encounter when managing obesity in general practice. Application of the TDF and BCW frameworks identified complex interactions between knowledge, beliefs, and environmental factors influencing GP behavior. These findings highlight key areas for targeted interventions to enhance obesity care and drive best practice. A qualitative study explored general practitioners' (GPs') influences on obesity management practices and identified potential targets for intervention. The Theoretical Domains Framework and Behavior Change Wheel informed the analysis, highlighting the influence of multiple factors on current practices. The findings suggest that future interventions should target GPs' knowledge and skills and the broader clinical environment to promote best practices in obesity management. Collaborative development of interventions with GPs is recommended to ensure optimal impact.
A Pilot Feasibility Study Exploring the Preliminary Effectiveness of an AI‐Driven Virtual Human Intervention for General Practitioner Obesity Education and Communication‐Skills Training
Background Rising global obesity rates demand effective weight management strategies from general practitioners (GPs). However, time constraints, training gaps, and low confidence often impede GPs' ability to conduct weight‐based conversations. This pilot study assessed the feasibility and preliminary effectiveness of an AI‐driven Virtual Human (VH) obesity education and communication‐skills training tool, specifically designed to address these challenges and enhance obesity education and communication‐skills among GPs. Methods A pilot feasibility study with a pre‐post survey design evaluated the impact of the VH tool on knowledge, self‐efficacy, empathy toward patients with obesity, and confidence in clinical consultations. Participant perceptions, trust, and intention to use the VH tool were explored. Paired‐sample t‐tests were conducted to evaluate within‐group mean differences. Descriptive statistics were used to evaluate feasibility and acceptability. Results A total of 22 GPs were recruited. Despite some attrition, significant improvements were observed in knowledge (p = 0.006), self‐efficacy (p = 0.001), and combined empathy and confidence scores (p = 0.002). Alongside these improvements, participants demonstrated positive perceptions of the tool, high trust in the VH, and a strong intention to implement the learned strategies. Conclusions This pilot study demonstrates the potential of an AI‐driven VH tool to enhance GP obesity education and communication skills. The observed improvements in key outcomes support the potential of VH technology in medical education on obesity. To further establish the efficacy and explore the broader applicability, future research should focus on larger, controlled trials across various provider groups. Overall, these preliminary observations highlight a promising avenue for enhancing the skills of a wider range of providers in the obesity treatment space.
Weight Stigma Responses: Patient Perceptions and Experiences of Interactions With Healthcare Professionals Across Healthcare Settings–A Qualitative Evidence Synthesis Protocol
Background: Weight stigma is enacted by healthcare providers across healthcare settings where it has been consistently shown to contribute to poor physical health outcomes and the maintenance of obesity via physiological, cognitive, emotional and behavioural pathways. Despite key stakeholders identifying obesity as a disease, people with obesity continue to experience denigration and discrimination, particularly in healthcare settings. Qualitative studies which capture the experience of enacted weight stigma from the patient perspective can increase awareness of how stigma presents within patient-provider interactions and ultimately inspire change in healthcare provision. The current review aims to systematically search for and synthesise enacted weight stigma experienced in primary, secondary and tertiary healthcare settings, explicitly from the patient perspective. Methods: Electronic searches will be conducted in PubMed, Medline, PsycInfo, Cinahl, Embase and Scopus to locate relevant studies published in English from May 2011. Two reviewers will independently conduct title and abstract screening and full text screening, any disagreements will be resolved through discussion with a third reviewer. The methodological quality of the included studies will be appraised using the critical appraisal skills programme (CASP) check list. A thematic synthesis will be conducted by the lead author in collaboration with the review team. Confidence in the review findings will be assessed by the review team using GRADE CERQual. Discussion: It is anticipated that the findings of the review will facilitate a deep and broad understanding of the patient experience to inform best practice and future intervention design.
The experiences of people living with obesity and chronic pain: A Qualitative Evidence Synthesis
There is a substantial and progressive association between chronic pain (CP) and living with overweight or obesity. The relationship between obesity and CP is intricate and complex, with obesity being associated with increased pain-related disability, pain intensity, reduction in physical functioning and poorer psychological well-being. A Qualitative Evidence Synthesis (QES) provides an opportunity to better understand and reveal key areas within the patient experience of these complex interactions to inform best practice and future intervention design. The aim of this QES is to methodically and systematically review and synthesise the qualitative literature reporting on the personal experiences of people who are both living with obesity (PwO) and chronic pain. The phenomenon of interest of this QES is the lived experiences of PwO and CP. The following research question was developed using a modified Population, Intervention, Comparison, Outcome and Study type (PICOS) framework: \"What are the lived experiences of people living with obesity and chronic pain?\". One review author will conduct a systematic search based on keywords and Medical Subject Headings (MeSH) terms for finding relevant articles in five peer-review databases, from inception to the date of searching. Two review authors will independently apply inclusion and exclusion criteria and screen articles in a two-stage process. The methodological quality of included studies will be assessed using the Critical Appraisal Skills Programme (CASP) tool and data will be extracted using a customised template. We will undertake a thematic synthesis of qualitative data from included studies and report our findings narratively. Confidence in the findings will be assessed based on the Grading of Recommendations Assessment, Development and Evaluation Confidence in Evidence from Reviews of Qualitative Research (GRADE-CER-Qual) approach. This study will follow the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA) and Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guidelines. It is anticipated that the findings of the review will facilitate a deep and broad understanding of the complex interactions between CP and obesity and will help inform best practice and future intervention design. Findings will be disseminated through journals that undergo peer review, presentations at conferences, engagement with public and patient advocacy groups, and social media.
The experiences of people living with obesity and chronic pain: A Qualitative Evidence Synthesis
There is a substantial and progressive association between chronic pain (CP) and living with overweight or obesity. The relationship between obesity and CP is intricate and complex, with obesity being associated with increased pain-related disability, pain intensity, reduction in physical functioning and poorer psychological well-being. A Qualitative Evidence Synthesis (QES) provides an opportunity to better understand and reveal key areas within the patient experience of these complex interactions to inform best practice and future intervention design. The aim of this QES is to methodically and systematically review and synthesise the qualitative literature reporting on the personal experiences of people who are both living with obesity (PwO) and chronic pain. The phenomenon of interest of this QES is the lived experiences of PwO and CP. The following research question was developed using a modified Population, Intervention, Comparison, Outcome and Study type (PICOS) framework: \"What are the lived experiences of people living with obesity and chronic pain?\". One review author will conduct a systematic search based on keywords and Medical Subject Headings (MeSH) terms for finding relevant articles in five peer-review databases, from inception to the date of searching. Two review authors will independently apply inclusion and exclusion criteria and screen articles in a two-stage process. The methodological quality of included studies will be assessed using the Critical Appraisal Skills Programme (CASP) tool and data will be extracted using a customised template. We will undertake a thematic synthesis of qualitative data from included studies and report our findings narratively. Confidence in the findings will be assessed based on the Grading of Recommendations Assessment, Development and Evaluation Confidence in Evidence from Reviews of Qualitative Research (GRADE-CER-Qual) approach. This study will follow the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA) and Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guidelines. It is anticipated that the findings of the review will facilitate a deep and broad understanding of the complex interactions between CP and obesity and will help inform best practice and future intervention design. Findings will be disseminated through journals that undergo peer review, presentations at conferences, engagement with public and patient advocacy groups, and social media.
The experiences of people living with obesity and chronic pain: A Qualitative Evidence Synthesis
There is a substantial and progressive association between chronic pain (CP) and living with overweight or obesity. The relationship between obesity and CP is intricate and complex, with obesity being associated with increased pain-related disability, pain intensity, reduction in physical functioning and poorer psychological well-being. A Qualitative Evidence Synthesis (QES) provides an opportunity to better understand and reveal key areas within the patient experience of these complex interactions to inform best practice and future intervention design. The aim of this QES is to methodically and systematically review and synthesise the qualitative literature reporting on the personal experiences of people who are both living with obesity (PwO) and chronic pain. The phenomenon of interest of this QES is the lived experiences of PwO and CP. The following research question was developed using a modified Population, Intervention, Comparison, Outcome and Study type (PICOS) framework: \"What are the lived experiences of people living with obesity and chronic pain?\". One review author will conduct a systematic search based on keywords and Medical Subject Headings (MeSH) terms for finding relevant articles in five peer-review databases, from inception to the date of searching. Two review authors will independently apply inclusion and exclusion criteria and screen articles in a two-stage process. The methodological quality of included studies will be assessed using the Critical Appraisal Skills Programme (CASP) tool and data will be extracted using a customised template. We will undertake a thematic synthesis of qualitative data from included studies and report our findings narratively. Confidence in the findings will be assessed based on the Grading of Recommendations Assessment, Development and Evaluation Confidence in Evidence from Reviews of Qualitative Research (GRADE-CER-Qual) approach. This study will follow the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA) and Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guidelines. It is anticipated that the findings of the review will facilitate a deep and broad understanding of the complex interactions between CP and obesity and will help inform best practice and future intervention design. Findings will be disseminated through journals that undergo peer review, presentations at conferences, engagement with public and patient advocacy groups, and social media.