BACKGROUND Overweight in children is a rising problem leading to serious consequences later in life. The Dutch guideline 'Obesity' for general practitioners recommends discussing obesity in children regardless of the reason of consultation and provides diagnostic and therapeutic tools. However, limited literature indicates that general practitioners experience barriers to discuss this topic. The aim of this study was to determine current perceived barriers of general practitioners in discussing overweight during a regular consultation in children aged 4 to 12 years and to what extent they discuss the topic. Furthermore, we attempt to get more insight in the specific needs and ideas for improvement among GPs. METHODS A semi-structured in-depth interview study was conducted. Dutch general practitioners with a broad range of demographic characteristics were invited to participate. The transcripts were analysed using a modified version of the constant comparative method. Using this method, we identified perceived barriers of general practitioners. RESULTS Ten general practitioners were included in the study. Four major themes were identified in the interviews: absence of physical or mental complaints related to overweight, internal barriers of the general practitioners, the child's family background and logistics. Major barriers appeared to be a low consultation rate of these children, the sensitivity of the topic (e.g. fear for children's or parents' reactions and/or disturbance of the relation, influence on the self-esteem of the child, resistance in the parents), the absence of a long-standing relation between general practitioner and child or parent, the background of the child and lack of time or prioritizing. CONCLUSION Dutch general practitioners indicate to experience barriers and need tools for how to discuss children's overweight during regular consultations within the limited time available. The low consultation rate among children aged 4 to 12 years due to lack of physical complaints is mentioned as a new and important barrier. Therefore, the prior focus might be raising awareness among parents concerning overweight in children aged 4 to 12 years and, thereby, stressing the potential supporting role of primary care professionals in tackling the overweight of their child.

中文翻译：

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在常规的常规咨询中讨论儿童超重：定性研究。

背景技术儿童的超重是一个日益严重的问题，导致以后生活中的严重后果。荷兰针对一般从业者的“肥胖症”指南建议不考虑咨询原因而讨论儿童肥胖症，并提供诊断和治疗工具。但是，有限的文献表明，全科医生在讨论此主题时遇到障碍。这项研究的目的是确定在4到12岁儿童的常规咨询过程中，全科医生目前在讨论超重方面存在的公认障碍，以及他们在多大程度上讨论该话题。此外，我们试图在GP的特定需求和改进方面获得更多见解。方法进行了半结构化深度访谈研究。具有广泛人口特征的荷兰全科医生被邀请参加。使用常数比较方法的改进形式分析转录本。使用这种方法，我们确定了全科医生的感知障碍。结果该研究包括十名全科医生。访谈中确定了四个主要主题：没有与超重有关的身体或精神上的抱怨，全科医生的内部障碍，孩子的家庭背景和后勤。主要障碍似乎是这些孩子的咨询率低，主题的敏感性（例如，对孩子或父母的反应的恐惧和/或关系的干扰，对孩子自尊的影响，父母的抵制） ，全科医生与孩子或父母之间没有长期的关系，孩子的背景以及缺乏时间或优先次序。结论荷兰的全科医生表示要经历障碍，并且需要工具来在有限的时间内，通过定期的咨询来讨论儿童的超重问题。由于缺乏身体不适，在4至12岁的儿童中低咨询率被认为是一个新的重要障碍。因此，先前的重点可能是提高父母对4至12岁儿童超重的认识，从而强调初级保健专业人员在解决孩子超重方面的潜在支持作用。结论荷兰的全科医生表示要经历障碍，并且需要工具来在有限的时间内，通过定期的咨询来讨论儿童的超重问题。由于缺乏身体不适，在4至12岁的儿童中低咨询率被认为是一个新的重要障碍。因此，先前的重点可能是提高父母对4至12岁儿童超重的认识，从而强调初级保健专业人员在解决孩子超重方面的潜在支持作用。结论荷兰的全科医生表示要经历障碍，并且需要工具来在有限的时间内，通过定期的咨询来讨论儿童的超重问题。由于缺乏身体不适，在4至12岁的儿童中低咨询率被认为是一个新的重要障碍。因此，先前的重点可能是提高父母对4至12岁儿童超重的认识，从而强调初级保健专业人员在解决孩子超重方面的潜在支持作用。由于缺乏身体不适，在4至12岁的儿童中低咨询率被认为是一个新的重要障碍。因此，先前的重点可能是提高父母对4至12岁儿童超重的认识，从而强调初级保健专业人员在解决孩子超重方面的潜在支持作用。由于缺乏身体不适，在4至12岁的儿童中低咨询率被认为是一个新的重要障碍。因此，以前的重点可能是提高父母对4至12岁儿童超重的认识，从而强调初级保健专业人员在解决孩子超重方面的潜在支持作用。