Female Perspectives Regarding Quality of Care and Weight-Related Communication in Obstetrics-Gynecology and Family Practices

Abstract

Background: The aim of this study was to evaluate the perspectives of patients with elevated body mass index (BMI) regarding the quality of care, communication, and the clinical office environment provided by obstetrics-gynecology (OBGYN) and family practices (FP) outpatient practices.

Methods: A cross-sectional 20-question survey was administered to female patients (18 years) with BMI 25 kg/m² at academic practices of OBGYN and FP clinics. Descriptive statistics and Chi-square tests were computed to assess differences by specialty. Unadjusted and adjusted ordinal regression analyses were conducted to assess factors associated with patient satisfaction with care.

Results: Responses from 330 patients (150 OBGYN and 180 FP) were included. The majority of women were between the ages of 31 and 50 (44.5%), reported BMI with class III obesity category (41.5%), and had a high school diploma or less (67.4%). Regarding clinical environment, a higher proportion of OBGYN patients (36.7% vs. 12.5%, P < 0.001) reported weight scales not being located in a private setting compared with FP patients. A higher proportion of OBGYN patients than FP patients (15.0% vs. 7.9%) felt their physicians were not understanding of what it meant to have overweight/obesity (P = 0.014) and felt their physician was uncomfortable when discussing weight-loss treatments (14.2% vs. 11.7%, P = 0.009). However, a higher proportion of FP patients than OBGYN patients (14.2% vs. 6.2%) were dissatisfied with the overall level of care (P = 0.004). There were no significant differences in the quality of treatment, level of courtesy and respect utilized during treatment.

Conclusion: Perceptions of weight-related communication and the clinical environment were significantly worse by OBGYN compared to FP patients with elevated BMI. However, satisfaction with overall level of care was significantly higher for OBGYN patients compared to FP patients. This suggests a continued need for training related to weight stigma and best practices for creating a welcoming environment in OBGYN clinics.

J Clin Gynecol Obstet. 2024;13(2):25-34
doi: https://doi.org/10.14740/jcgo953