Abstract:
OBJECTIVE:To deliver effective care, healthcare systems should understand patients' preferences for weight management across a spectrum of needs. Our objective was to describe patients' perceptions of what helps or hinders weight loss and maintenance. METHODS:Semistructured interviews were conducted with patients who accessed weight management services at a large integrated health system in 2018. The interview guide was developed and iteratively refined through a literature search and by consulting experts. Questions included the respondent's weight history, interactions with the health system, and current health status. The analysis used a grounded theory approach, and each transcript was double-coded in 2019. Codes were sorted into themes. All discrepancies were resolved through team discussion. RESULTS:Fifteen patients were interviewed. The majority of respondents (87%) reported multiple weight loss attempts. Three themes were identified. First, advice should be matched to a patient's knowledge and prior experience (eg, using bariatric deck cards). As patients progressed, clinician advice also needed to advance (eg, explaining how to expand food options instead of defining a healthy diet). Second, respondents had a variety of motivating factors, and understanding where motivation is generated from can inform how to design a weight management approach. Third, patients need continual and long-term advice. Some respondents feared becoming ineligible for services if their weight dropped too much. CONCLUSIONS:Health systems can support patients by developing processes for identifying the extent of a patient's knowledge and giving personalized advice based on the patient's preferences and experiences. Reassessing needs at defined intervals may help patients attain and sustain their goals.
journal_name
South Med Jjournal_title
Southern medical journalauthors
Pfoh ER,Flench R,Varghai NH,King M,Heinberg LJdoi
10.14423/SMJ.0000000000001196subject
Has Abstractpub_date
2021-01-01 00:00:00pages
41-45issue
1eissn
0038-4348issn
1541-8243pii
SMJ50880journal_volume
114pub_type
杂志文章abstract:OBJECTIVES:Studies have shown that the overutilization of laboratory tests ("labs") for hospitalized patients is common and can cause adverse health outcomes. Our objective was to compare the ordering tendencies for routine complete blood counts (CBC) and chemistry panels by internal medicine residents and hospitalists...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000000592
更新日期:2017-01-01 00:00:00
abstract::This report describes the case of a 32-year-old male presenting with acute progressive bilateral carpal tunnel syndrome after a benign upper respiratory tract infection. Serial nerve conduction studies confirmed progressive entrapment of the median nerves in the carpal tunnel to the point of axonal damage. Surgical de...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.smj.0000182502.23548.41
更新日期:2005-11-01 00:00:00
abstract::Whipple disease (WD) is a rare disease caused by Tropheryma whipplei. The classic profile of the patient is that of a middle-aged man presenting with fever, chronic diarrhea, and arthralgias. Extragastrointestinal manifestations are not rare. A high degree of clinical suspicion for the disease is needed in atypical ca...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e3181d3949c
更新日期:2010-04-01 00:00:00
abstract::The incidence of cocaine-induced psychosis has increased with the rise in popularity of cocaine as the recreational drug of choice. Neuroleptic agents have been used to control the hallucinations, paranoia, and hyperactivity of the acute psychotic episodes. Lithium has been suggested as an alternative therapeutic agen...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198112000-00015
更新日期:1981-12-01 00:00:00
abstract::Many factors contribute to the attainment of adult height, including genetic and environmental variables. To assess the relationship between menarcheal age and adult height, measured adult height and recalled menarcheal age were compared by regression analysis in 425 women. The overall regression equation, Height = 15...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198904000-00009
更新日期:1989-04-01 00:00:00
abstract::Sarcoidosis is a multisystem disorder of unknown cause, characterized pathologically by noncaseating granulomas. It is more commonly seen in younger adults and African Americans. Myocardial involvement occurs in at least 25% of patients with sarcoidosis and is associated with poor prognosis. In spite of recent advance...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e318189570e
更新日期:2008-10-01 00:00:00
abstract::We have described a case of peripelvic extravasation of urine caused by lower ureteral obstruction from a breech presentation in a 20-year-old primigravida. The patient was successfully treated with cesarean section to relieve the obstruction, and systemic antibiotics. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198006000-00043
更新日期:1980-06-01 00:00:00
abstract::Interruption of the inferior vena cava by the transvenous placement of a filter or umbrella effectively prevents pulmonary embolism by acting primarily as a physical barrier to emboli. Such a device will be effective only if the site of thrombosis is distal to the planned placement site. We have presented two cases in...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198906000-00025
更新日期:1989-06-01 00:00:00
abstract::Endocrine metabolic emergencies are common clinical entities seen by most health care professionals in acute care medicine. Except for cardiopulmonary arrest, few situations require such rapid institution of immediate drug therapy to reverse life-threatening metabolic imbalances. To safely guide patients through these...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/00007611-198402000-00021
更新日期:1984-02-01 00:00:00
abstract::A case of Reiter's syndrome associated with a dissecting popliteal cyst mimicking deep vein thrombophlebitis is reported. The cyst was diagnosed by arthrography and responded to intra-articular injection of corticosteroids. The diagnosis of a dissecting popliteal cyst should be considered in a patient with arthritis o...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:1976-11-01 00:00:00
abstract::The results of radiation therapy of 79 patients with early carcinoma of the vocal cord are reported. Nine (13%) of the 69 patients with stage I disease had local recurrence, and two (20%) of the ten patients with stage II disease had local recurrence without local node metastasis. Subsequent control of radiation failu...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197901000-00004
更新日期:1979-01-01 00:00:00
abstract::We reviewed our experience with thyroid sonography of 60 patients with nonfunctioning (cold) solitary thyroid nodules proven by iodine 123 scan. Twenty-two patients had surgery; the remaining 38 had thyroid scan and ultrasound only. In the first group, the echograms did not demonstrate the surgically proven nodules in...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198409000-00024
更新日期:1984-09-01 00:00:00
abstract::We have used the island gluteus maximus musculocutaneous flap to cover sacral pressure sores. In this report, we describe the surgical anatomy, cadaveric dissections (n = 25), and postoperative follow-up (one to 40 months) in 13 clinical cases. Our results compare favorably with those of other previously reported seri...
journal_title:Southern medical journal
pub_type: 临床试验,杂志文章
doi:
更新日期:1985-10-01 00:00:00
abstract::A total of 37 physicians and other health care professionals have been accepted into a monitoring and advocacy program for an average of 24 months. Thirty-five are working in their profession, one is in treatment, and one has repeatedly relapsed and is no longer practicing medicine (an overall improvement rate of 97%)...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199409000-00003
更新日期:1994-09-01 00:00:00
abstract::Payment systems in the US healthcare system have rewarded physicians for services and attempted to control healthcare spending, with rewards and penalties based upon projected goals for future spending. The incorporation of quality goals and alternatives to fee-for-service was introduced to replace the previous system...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000000626
更新日期:2017-04-01 00:00:00
abstract::A 42-year-old woman had dysentery caused by the Shiga bacillus, Shigella dysenteriae type 1, while taking diphenoxylate with atropine during and after her return from a trip to Mexico. Although she was treated with appropriate antibiotics, she suffered a prolonged and toxic acute course followed by intermittent bouts ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198003000-00034
更新日期:1980-03-01 00:00:00
abstract::Cardiac rupture due to blunt trauma has been recognized with increasing frequency over the past two decades. The mortality rate is high and the majority of patients die before they arrive at the emergency department. A high index of suspicion and prompt surgical intervention are crucial for survival. We report the man...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199707000-00019
更新日期:1997-07-01 00:00:00
abstract::We describe the case of a patient with acquired immunodeficiency syndrome (AIDS) who had a CD4 cell count of 60/microL, bilateral hilar adenopathy, and hypercalcemia. Transbronchial biopsy showed T-cell anaplastic large cell lymphoma. Serology was negative for human T-cell leukemia virus-I (HTLV-I). This appears to be...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:2000-09-01 00:00:00
abstract::This case presents a rare type of crescentic glomerulonephritis characterized as IgA deposits predominantly along the glomerular basement membranes (GBM). The patient clinically manifested with rapidly progressive glomerulonephritis (RPGN) without pulmonary hemorrhage or vasculitis-related systematic symptoms. No posi...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e3181817c22
更新日期:2008-09-01 00:00:00
abstract::An 86-year-old diabetic man had a late, gas-forming infection about Knowles pins. Although blood cultures were negative, a urinary tract infection followed by infection with the same organism in bone, muscle, and lung strongly supports hematogenous spread of E coli from the genitourinary system in this patient. The ge...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:1983-02-01 00:00:00
abstract::Millions of concussions occur every year in the United States. The public interest in concussion has increased after a number of high-profile deaths in high school athletes from sports-related head trauma and in some professional athletes from chronic traumatic encephalopathy. One of the most active areas of research ...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/SMJ.0000000000000064
更新日期:2014-02-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to determine the relation among multiple morbidities and the prevalence of colorectal cancer (CRC) screening among older adult Appalachian residents of Kentucky. This is the first known study to address multiple morbidities exclusively with a health-disparities population. METH...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e31823a8879
更新日期:2011-12-01 00:00:00
abstract::Recommendations concerning postoperative extubation after thymectomy for myasthenia gravis are presently based upon retrospective chart reviews. We present the results of a prospective investigation of time to extubation after thymectomy for 14 patients over a 12-month period based upon a protocol that included preope...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199106000-00007
更新日期:1991-06-01 00:00:00
abstract::Children with sickle cell anemia who were less than 5 years old were observed over a three-year period. Those born to recent Haitian immigrants accounted for 108.4 patient-years. They had seven episodes of Streptococcus pneumoniae bacteremia and five due to Haemophilus influenzae for rates of 6.5 and 4.6 episodes per ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198907000-00009
更新日期:1989-07-01 00:00:00
abstract::An elderly woman complaining of a gait disorder was found to have the GALOP syndrome (gait ataxia, late-onset polyneuropathy). She exhibited mild distal weakness and sensory loss in the legs, a positive Romberg, and an unsteady gait. Serum immunofixation disclosed a monoclonal IgM-kappa protein. There was specific IgM...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.SMJ.0000117799.38569.B8
更新日期:2004-04-01 00:00:00
abstract::A 66-year-old woman had sudden onset of portal hypertension manifested by diarrhea, ascites, and varices. When a splenic arteriovenous fistula was found to be the cause, the fistula was resected. Her signs and symptoms did not recur. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198805000-00033
更新日期:1988-05-01 00:00:00
abstract::Despite recent pharmacologic advances in the prevention and treatment of osteoporosis, the disease remains incurable. Effective disease management ultimately lies in the hands of the individual patient, who must take responsibility for key health behaviors related to bone health. One behavior modification strategy tha...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-200406000-00007
更新日期:2004-06-01 00:00:00
abstract::Gaseous distention of the stomach at the time of arteriography enhances the contrast of densities within the pancreatic parenchyma, resulting in excellent visualization and therefore precise preoperative localization of insulin-secreting tumors of the pancreas. This relatively simple modification of selective arteriog...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198312000-00017
更新日期:1983-12-01 00:00:00
abstract:OBJECTIVES:Anemia, either chronic or newly developed in the hospital as a result of underlying disease and/or phlebotomy, is seen commonly among general medical inpatients, and its impact on the quality and efficiency of care is unknown. METHODS:This study investigated the relation among hemoglobin level, length of st...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e318290f930
更新日期:2013-05-01 00:00:00
abstract:BACKGROUND:The decision to place a percutaneous feeding tube (PFT) in patients who are at the end of life is multidimensional and often complicated. We assessed the effect of physician education and counseling for patients and their surrogates on inpatient nonsurgical (endoscopic and radiologic) PFT placement rates, in...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e3181c9800f
更新日期:2010-02-01 00:00:00