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Title: A new approach to the management of weight problems in a primary health care setting.
Authors: Xuereb, Elizabeth
Keywords: Primary health care -- Malta
Body weight
Issue Date: 2004
Citation: Xuereb E. (2004). A new approach to the management of weight problems in a primary health care setting. (Master's dissertation).
Abstract: Obesity has over the past few decades become a global public health problem and in Malta there is a high prevalence of overweight and obesity in adults as indicated by the WHO MONICA study carried out in 1984. The aims and objectives of this research were to determine the prevalence of weight problems of doctors and nurses working in the Maltese governmental Primary Health Care Department by means of a questionnaire; to look at their general health, dietary habits and lifestyles; to assess their awareness of weight problems, prejudice, positive and negative attitudes and to analyze their comments and suggestions and to make recommendations on how to increase the involvement of primary care professionals in dealing with weight problems. Deficiencies in relation to training and communication skills of doctors and nurses were also explored together with suggestions for dealing with these problems. The study population consisted of one hundred and fifty one doctors and nurses working at all the Health Centres in Malta, within the Primary Health Care Department. Besides answering a questionnaire, the study population had measurements of height and weight recorded by means of a stadiometer; the body mass index (BM I) could therefore be calculated. The waist circumference was measured in centimeters, by means of a standard tape measure and in fifty five individuals skinfold thicknesses were measured with calipers to estimate body fat percentage. The results showed that there was a moderately high prevalence of overweight and lower grades of obesity in doctors and nurses, especially in males. Although the study subjects knew what constituted a healthy diet, their irregular and long working hours made it difficult for them to maintain a healthy weight, this being exacerbated by a general lack of physical exercise. The risk of developing three main complications of excess weight: Type 2 diabetes mellitus, hypertension and coronary vascular disease was assessed using each subject's 8M I and waist circumference. In general, males from all categories had the highest disease risk whilst in females, risk, although present, was not so pronounced except for female nursing officers, due to their sedentary jobs. A training deficit and poor communication skills were found to be present as regards the management of patients with weight problems in both doctors and nurses. Special training courses in weight management were recommended by the majority of these healthcare professionals. The idea of setting up of 'Weight Management Clinics' at the Primary Health Care level was well supported by the great majority of doctors and nurses. These clinics, which would be a new innovation, in the Maltese governmental Primary Health care setting, would comprise a team consisting of a physician specialized in dealing with overweight and obesity, a nurse, a nutritionist, an exercise physiologist and a psychologist. This team would receive referrals of patients with excess weight problems, from both the primary and the secondary health care spheres in Malta. A holistic approach to the management of these patients would then be guaranteed which would result in successful weight reduction and healthy weight maintenance throughout life.
Description: M.SC. PUBLIC HEALTH
Appears in Collections:Dissertations - FacM&S - 2004
Dissertations - FacM&SPH - 2004

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