Dymek Maureen P, Le Grange Daniel, Neven Kim, Alverdy John
Department of Psychiatry and. Department of Surgery, The University of Chicago Hospitals, Chicago, Illinois, USA.
Obes Res. 2002 Nov;10(11):1135-42. doi: 10.1038/oby.2002.154.
Numerous reports document significant weight loss after gastric bypass; however, there is little objective data on postsurgical changes in health-related quality of life (HRQL).
This study examined HRQL in four groups of patients: presurgery (T1), several weeks postsurgery (T2), 6 months postsurgery (T3), and 1 year postsurgery (T4). Subjects were given three HRQL measures: the short form 36 (SF-36), the Impact of Weight on Quality of Life-Lite Questionnaire (IWQOL-Lite), and the Bariatric Analysis and Reporting Outcome System (BAROS). Subjects also completed the Beck Depression Inventory (BDI) and the Rosenberg Self-Esteem Scale (RSE).
There were no significant differences among the groups on demographics or presurgical body mass index. Results showed significant differences between T1 and T2 on several SF-36 and IWQOL-Lite subscales, as well as the RSE and BDI. Significant differences were found on all measures between T2 and T3. Significant differences were found on all subscales of the IWQOL-Lite, but no subscales of the SF-36, the RSE, or the BDI between T3 and T4.
This study is the first to objectively document these differences in several objective measures of HRQL, depression, and self-esteem after gastric bypass in a large sample. It is notable that many differences are apparent within several weeks after surgery. Furthermore, results indicate that the IWQOL-Lite may be more sensitive than the SF-36 to the changes of quality of life that gastric bypass patients report.
众多报告记录了胃旁路术后显著的体重减轻情况;然而,关于术后健康相关生活质量(HRQL)变化的客观数据却很少。
本研究对四组患者的HRQL进行了检查:术前(T1)、术后几周(T2)、术后6个月(T3)和术后1年(T4)。受试者接受了三项HRQL测量:简短健康调查问卷36项版本(SF - 36)、体重对生活质量影响简易问卷(IWQOL - Lite)以及肥胖症分析与报告结果系统(BAROS)。受试者还完成了贝克抑郁量表(BDI)和罗森伯格自尊量表(RSE)。
各组在人口统计学特征或术前体重指数方面无显著差异。结果显示,在几个SF - 36和IWQOL - Lite子量表以及RSE和BDI上,T1和T2之间存在显著差异。在T2和T3之间的所有测量指标上均发现显著差异。在IWQOL - Lite的所有子量表上发现显著差异,但在T3和T4之间,SF - 36、RSE或BDI的任何子量表上均未发现显著差异。
本研究首次在大样本中客观记录了胃旁路术后在HRQL、抑郁和自尊的几个客观测量指标上的这些差异。值得注意的是,许多差异在术后几周内就很明显。此外,结果表明,IWQOL - Lite可能比SF - 36对胃旁路手术患者报告的生活质量变化更敏感。