Fysioterapeuten 5-2021

FYSIOTERAPEUTEN 5/21 53 Konklusjon Studien viser hvordan fysioterapeuter forstår og forhol- der seg til overvekt som en større kompleksitet. Deres til- nærming til overvekt beveges i et spenn mellom fokus på endring og aksept av pasientens kropp. Fysioterapeutene legger mer vekt på funksjonsforbedring enn vektreduk- sjon, noe som kan forstås som uttrykk for aksept av pa- sientens kropp. Funnene indikerer samtidig at normative holdninger kommer til uttrykk i og påvirker møtene mel- lom pasient og fysioterapeut, selv om de prøver å unngå stigmatisering av overvektige pasienter. Det er behov for en overordnet profesjonell diskurs som gir retning for en profesjonell praksis med fokus på aksept og ikke-diskrimi- nering. Referanser 1. Helsedirektoratet. Forebygging, utredning og behandling av overvekt og fedme hos voksne: nasjonal faglig retningslinje. Oslo: Helsedirektoratet; 2011. IS-1735. https://www.helsedirektoratet.no/retningslinjer/overvekt-og- fedme-hos-voksne 2. 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Tidsskrift for Den norske legeforening 2020;16. Doi:10.4045/ tidsskr.20.0103; hentet 21.11.2020 24. Aspenes MT. Overvektens kompleksitet - Psykomotorisk fysioterapi som behandling ved overvekt. Masteroppgave i helsefag, Tromsø: Universitetet i Tromsø; 2016. 25. Dahl-Michelsen T, Groven K, Aadland E. Profesjonsetikk i ergoterapi og fysioterapi (Professional ethics in occupational therapy and physiotherapy). Oslo: Samlaget; 2018. 26. Braithwaite J, Dahl-Michelsen T, Groven KS. How are we doing? Placing human relationships at the centre of physiotherapy. Mobilizing Knowledge in Physiotherapy: Critical Reflections on Foundations and Practices. 2020:197. 27. Babatunde F, MacDermid J, MacIntyre N. Characteristics of therapeu- tic alliance in musculoskeletal physiotherapy and occupational therapy practice: a scoping review of the literature. BMC health services research. 2017;17(1):375. Doi: 10.1186/s12913-017-2311-3 28. Hanstvedt MH, Løken HS. Kommunikasjon gir svar. Fysioterapeuten. 2016;10:34-36. 29. Sylliaas H, Svendsen T, Langaas AG, et.al . Hvordan tilpasse fysiote- rapipraksis til sårbare brukergrupper? Fysioterapitilnærminger belyst gjennom teorier om tilfriskning og sosial bevisstgjøring. Fysioterapeuten. 2020;87(8):18-22 30. Silk AW, McTigue KM. Reexamining the Physical Examination for Obese Patients. JAMA. 2011;305(2):193–194. Doi: 10.1001/jama.2010.1950 Abstract Physiotherapists understandings of overweight in clinical practice: an interview study Purpose : To examine how physiotherapists understand and relate to overweight in clinical practice. Design, material and method : Thematic analysis of individual in-depth interviews with four physiothera- pists working in different types of clinical physiothe- rapy practice. Findings : Overweight is thematized in different ways and understood and related to as a part of a wholeness that contributes to and/or helps maintain the patient’s problem. The wholeness is also understood as a larger complexity in which the understanding of overweight spans out to both focus on change as well as accep- tance. In their clinical practice, the physiotherapists emphasize on functional improvement rather than weight reduction. The results indicate that normative attitudes influence their practice, whilst the physio- therapists simultaneously are careful not to stigmatize their patients, although this practice lacks an overall professional discourse on this topic. Conclusion : Given the lack of results with current tre- atments of overweight patients, we believe there is a need to enhance physiotherapists’ professional practice in this field. This can be achieved by having a greater focus on acceptance of the patient’s body size, rather than change. Our argument supporting this is that the overall goal of physiotherapy, namely helping a patient gain the best possible function with the body that they are and have, also applies to the overweight patient. Keywords : Overweight, clinical physiotherapy practice, weight-stigmatization.

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