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垂直带襻胃成形术后成功的社会心理预测因素。

Psychosocial predictors of success after vertical banded gastroplasty.

机构信息

Department of Medical Psychology, Catharina Hospital, P.O. box 1350, 5602 ZA, Eindhoven, The Netherlands.

出版信息

Obes Surg. 2009 Jun;19(6):701-7. doi: 10.1007/s11695-008-9446-6. Epub 2008 Mar 4.

DOI:10.1007/s11695-008-9446-6
PMID:18317854
Abstract

BACKGROUND

Psychosocial and behavioral factors contribute to successful postoperative outcomes. Patients' psychological factors may be predictive of postsurgical adjustment. The identification of these factors would allow targeting patients at risk of a poor outcome. Furthermore, it would enable better patient selection and preoperative and/or postoperative counseling to improve long-term outcomes. Unfortunately, no such consistent and reproducible predictors have been found so far.

METHODS

The present study investigated in morbid obese patients who underwent vertical banded gastroplasty (VBG) the predictive value of preoperative parameters, especially health-related quality of life (HRQoL), personality, psychosocial functioning, body image, and eating behavior for 2-year changes in these variables, as well as weight loss.

RESULTS

Two years after VBG, patients had significant weight loss and reported improvements in physical HRQoL, personality and psychosocial functioning, body image, and eating behavior. Although we were not able to find psychosocial predictors of excess weight loss or excess body mass index loss 2 years after VBG, we did find psychosocial predictors of 2-year changes in HRQoL, personality and psychosocial functioning, body image, and eating behavior.

CONCLUSION

Preoperative psychological assessment may not be necessary with respect to weight loss. However, it is helpful in targeting patients at risk of poor psychological outcomes after VBG.

摘要

背景

心理社会和行为因素有助于术后取得良好效果。患者的心理因素可能对术后适应有预测作用。识别这些因素将有助于发现预后不良风险较高的患者。此外,还可以更好地选择患者,并进行术前和/或术后咨询,以改善长期预后。遗憾的是,目前尚未发现具有一致性和可重复性的预测因素。

方法

本研究调查了接受垂直束带胃成形术(VBG)的病态肥胖患者,研究了术前参数(尤其是与健康相关的生活质量(HRQoL)、人格、心理社会功能、体像和饮食行为)对这些变量 2 年变化的预测价值,以及体重减轻。

结果

VBG 术后 2 年,患者体重明显减轻,身体 HRQoL、人格和心理社会功能、体像和饮食行为均有改善。尽管我们未能找到 VBG 术后 2 年体重过度减轻或体重指数过度减轻的心理社会预测因素,但我们确实发现了 2 年 HRQoL、人格和心理社会功能、体像和饮食行为变化的心理社会预测因素。

结论

就体重减轻而言,术前心理评估可能并非必要。然而,对于 VBG 后心理结局不良风险较高的患者,这种评估有助于确定目标人群。

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