BMJ Open (Nov 2023)

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

  • Grant Russell,
  • Elizabeth Ann Sturgiss,
  • Nor Akma Yunus,
  • Rosediani Muhamad

DOI
https://doi.org/10.1136/bmjopen-2022-071087
Journal volume & issue
Vol. 13, no. 11

Abstract

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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.