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青少年减重手术:术后第一年照顾者和家庭功能。

Adolescent bariatric surgery: caregiver and family functioning across the first postoperative year.

机构信息

Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.

出版信息

Surg Obes Relat Dis. 2011 Mar-Apr;7(2):145-50. doi: 10.1016/j.soard.2010.07.004. Epub 2010 Jul 29.

Abstract

BACKGROUND

The present study examined the psychological distress, parenting stress, and family functioning in female caregivers of adolescents undergoing bariatric surgery compared to that of caregivers of adolescents with extreme obesity not undergoing surgery across the first postoperative year.

METHODS

The female caregivers of 16 adolescents undergoing Roux-en-Y gastric bypass (mean age 16.6 years, mean body mass index 66.2 kg/m(2); 94% recruitment) and those of 28 comparison adolescents who had sought behavioral weight management (mean age 16.2 years, mean body mass index 46.3 kg/m(2); 90% recruitment) were included in the study. The caregivers completed measures of psychological distress (Symptom Checklist-90-Revised), parenting stress (Stress Index for Parents of Adolescents), and family functioning (Family Assessment Device) at baseline (before surgery) and at 6 and 12 months after surgery. Caregiver and adolescent anthropometric data were also obtained.

RESULTS

At baseline, clinical cutoffs were exceeded by 29.5% of the caregivers for psychological distress, 31.8% for family dysfunction, and 13.2% for parenting stress. Linear mixed modeling indicated that bariatric adolescents had a significantly greater body mass index at baseline than the comparison adolescents (t = -7.79, P <.001), with a substantial reduction by 12 months relative to the near-flat trajectory of the comparison group (t = 20.32, P <.001). No significant group differences at baseline or group trajectory differences were identified for any caregiver or family variable.

CONCLUSION

Our initial findings suggest that caregivers of adolescents with extreme obesity present with limited dysfunction and that bariatric surgery has no effect on caregiver distress, parenting stress, or family functioning across the first postoperative year. Larger samples and longer term follow-up will allow examination of what role caregiver/family factors play in the adolescent postoperative outcomes.

摘要

背景

本研究比较了接受减肥手术的青少年和未接受手术的极度肥胖青少年的女性照顾者的心理困扰、养育压力和家庭功能。

方法

研究纳入了 16 名接受 Roux-en-Y 胃旁路手术的青少年(平均年龄 16.6 岁,平均 BMI 为 66.2kg/m²;招募 94%)和 28 名接受行为体重管理的对照青少年的女性照顾者(平均年龄 16.2 岁,平均 BMI 为 46.3kg/m²;招募 90%)。照顾者在基线(手术前)和手术后 6 个月和 12 个月时完成了心理困扰(症状检查表-90-修订版)、养育压力(青少年父母压力指数)和家庭功能(家庭评估工具)的测量。还获得了照顾者和青少年的人体测量数据。

结果

基线时,29.5%的照顾者心理困扰超过临床临界值,31.8%的家庭功能障碍,13.2%的养育压力。线性混合模型表明,减肥青少年的基线 BMI 显著高于对照组(t = -7.79,P <.001),与对照组几乎持平的轨迹相比,12 个月时显著降低(t = 20.32,P <.001)。基线或组轨迹差异均未发现照顾者或家庭变量的显著组间差异。

结论

我们的初步发现表明,极度肥胖青少年的照顾者表现出有限的功能障碍,减肥手术在术后第一年对照顾者的困扰、养育压力或家庭功能没有影响。更大的样本量和更长的随访时间将有助于研究照顾者/家庭因素在青少年术后结局中所起的作用。

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