| Summary: | 碩士 === 國立陽明大學 === 醫務管理研究所 === 104 === Research Objective:
Obesity is one of the most important health issues worldwide. Although physicians are well-informed about health hazards of obesity, that do not make them immune from obesity. Physicians are an important cadre in health promotion efforts. However, there is only limited understanding of physician's health maintenance behaviors such as obesity and related risk-factors. The existing researches are mostly limited to single hospitals, small sample sizes, and the lack of discussions about potential influences of organizational factors. Therefore, this study aimed to determine the prevalence of overweight and obesity, and explore the influences of hospital environment and work characteristics on physician's overweight and obesity.
Study Design:
A nationwide survey of hospital employees, the data source was from Physical and Mental Health and Safety Needs in Health Care Full-Time Staff, and Hospital Supervisors Questionnaire which was conducted by Bureau of Health Promotion. The survey was conducted among full-time employees across 100 hospitals in Taiwan in 2011. We analyzed 4,087 full-time physicians (3,158 men and 929 women). The main dependent variable was body mass index (BMI), and BMI＞24 kg/m2 was defined as overweight and obesity by Health Promotion Administration in Taiwan. Independent variables include demographics, work characteristics and organizational characteristics (i.e. hospital ownership, accreditation level, efforts in health promotion, and access to healthy diets and fitness facilities). Multivariate regression analysis was adopted. Multilevel analysis were applied to control for hospital cluster. Descriptive Statistics were conducted. SAS 9.4 was used to do data analysis.
Results:
Nearly half (47.8 %) of physicians were overweight and obesity (30.5% overweight；17.3% obesity). Compared to the general population in Taiwan (43.0% overweight and obesity, Nutrition and Health Survey in Taiwan, 2013-2014). However, compared to the prevalence of overweight and obesity in general Taiwanese population, the prevalence of overweight and obesity among physicians was relatively higher than that reported in general Taiwanese population (43.0%). Furthermore, we found that the prevalence among male physicians was higher than general male population (57.1% vs. 48.9), but the prevalence among female physicians (16.0%) was substantially lower than general women population(38.3%). This principal finding showed that although physicians are knowledgeable regarding health hazards of overweight and obesity, they are still at a high risk of obesity. Risk factors included personality characteristic and organizational characteristics. Gender age, and married are significant predictors. Male, older age, and married physicians were statistically significantly associated with a higher risk of overweight and obesity. Surgeons or, obstetricians, and physicians who worked in emergency room or intensive care unit were more likely to be overweight and obesity (odds ratio1.22, 95% confidence interval 1.05-1.42). Furthermore, physicians with a longer working hours were more significantly more likely to be overweight and obesity than those with fewer working hours (odds ratio1.49, 95% confidence interval 1.18-1.88). However, organizational characteristics such as hospital ownership, accreditation level, and efforts in health promotion were not significant risk factors of overweight and obesity among physicians. However, more specifically, we found that physicians working in a hospital with either no or very few number of sport clubs were more likely to be overweight and obesity (odds ratio1.16, 95% confidence interval 1.00-1.35).
Conclusion:
The findings suggest that nearly half of the hospital physicians were either overweight or obese in Taiwan. The problem of obesity is particularly serious among male physicians. In addition to commonly recognized individual risk factors, work and organizational characteristics may also play a significant role.
Implications for Policy or Practice:
Although physicians are presumably better medically informed, their health maintenance behaviors may not be as good as expected. The findings raise public's attention on physician's health behaviors and illustrate the needs of more effective health promotion efforts in improving health in hospitals. In according to these risk factors we found, when doing human resource management, we could strengthen the health promotion and intervention on these risk groups (such as male, older, married physicians, work in urgent intensive field , high working hours population, and create exercise environment in the hospital) in the future.
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