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Patients' experience of accessing healthcare for obesity in Peninsular Malaysia: a qualitative descriptive study

Yunus NA 1 , Russell G 2 , Muhamad R 3 , Sturgiss EA 4

Affiliations 

  • 1 School of Primary and Allied Health Care, Monash University, Frankston, Victoria, Australia norakmabintiyunus@monash.edu norakmayunus@usm.my
  • 2 Department of General Practice, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
  • 3 Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
  • 4 School of Primary and Allied Health Care, Monash University, Frankston, Victoria, Australia
BMJ Open, 2023 Nov 21;13(11):e071087.
PMID: 37989390 DOI: 10.1136/bmjopen-2022-071087

Abstract

OBJECTIVE: To explore patients' experiences accessing healthcare for obesity and their perceived behaviour changes following the care.

DESIGN: Using a descriptive qualitative research approach informed by Levesque's framework of access to healthcare, we conducted phone interviews in the Malaysian language, which were audio-recorded and transcribed verbatim. Data were analysed inductively using a reflexive thematic analysis approach.

SETTING: Primary care clinics in five states in Peninsular Malaysia.

PARTICIPANTS: Adult patients with obesity receiving face-to-face care for obesity from healthcare providers in Peninsular Malaysia.

RESULTS: We interviewed 22 participants aged 24-62, with the majority being female (77%), Malay (95%), married (73%) and with tertiary education (82%). Most participants attended obesity management services at public primary care clinics. We identified five themes: (1) moving from perceiving the need to seeking obesity care is a non-linear process for patients, (2) providers' words can inspire patients to change, (3) patients' needs and preferences are not adequately addressed in current obesity care, (4) over-focusing on weight by patients and healthcare providers can lead to self-blame and loss of hope for patients and (5) obesity healthcare can have consequences beyond weight loss.

CONCLUSION: Patients lack the self-regulatory skills to continue their lifestyle changes and struggle with self-blame and hopelessness. Over-focusing on weight by patients and obesity healthcare increase patients' self-stigmatisation. While provider-initiated weight discussions and engaging and personalised consultation provide the initial step towards weight management, obesity healthcare could be enhanced by behavioural support and patient education on the complexity of obesity. Further considerations could be given to shifting from a weight-centric to a more holistic health-centred approach in obesity healthcare.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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