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减肥手术后患者的交叉成瘾可能性:初级保健执业护士的考量

The potential for cross-addiction in post-bariatric surgery patients: Considerations for primary care nurse practitioners.

作者信息

Bak Melissa, Seibold-Simpson Susan M, Darling Rosa

机构信息

Our Lady of Lourdes Hospital, Binghamton, New York.

Decker School of Nursing, Binghamton University/SUNY, Binghamton, New York.

出版信息

J Am Assoc Nurse Pract. 2016 Dec;28(12):675-682. doi: 10.1002/2327-6924.12390. Epub 2016 Jul 11.

Abstract

BACKGROUND AND PURPOSE

Possible mental health issues for post-bariatric surgery patients include the development of cross-addictions after the rapid weight loss period. No validated screening tool to assess for possible cross-addictions exists. The main purpose of this study was to develop recommendations for modifying an existing addiction screening tool (the Shorter PROMIS Questionnaire) for use by primary care providers.

METHODS

A qualitative descriptive design was used with triangulation of input from the scholarly literature, content experts (CEs), and post-bariatric surgery patients. Three focus groups were conducted with post-bariatric surgery patients (n = 12) with the same questions asked of the CEs (n = 3). Content analysis was used to analyze the transcripts.

CONCLUSIONS

The following themes regarding addictions after bariatric surgery were identified through consensus: alcohol, gambling, shopping, exercise, food starving/bingeing, and sexuality/relationships. Dissonant themes included caffeine and tobacco by the post-bariatric surgery patients and prescription/illicit medications by the CEs.

IMPLICATIONS FOR PRACTICE

Targeted screening for early identification of problem behaviors by primary care providers may result in appropriate referral to and management by mental health providers, assisting ongoing success of bariatric surgery.

摘要

背景与目的

减肥手术后患者可能出现的心理健康问题包括在快速减重期后形成交叉成瘾。目前尚无经过验证的筛查工具来评估可能的交叉成瘾情况。本研究的主要目的是制定建议,以修改现有的成瘾筛查工具(简版PROMIS问卷),供初级保健提供者使用。

方法

采用定性描述性设计,对学术文献、内容专家(CEs)和减肥手术后患者的意见进行三角验证。对减肥手术后患者(n = 12)进行了三个焦点小组讨论,并向内容专家(n = 3)提出了相同的问题。采用内容分析法对转录本进行分析。

结论

通过共识确定了以下关于减肥手术后成瘾的主题:酒精、赌博、购物、运动、食物饥饿/暴饮暴食以及性/人际关系。不一致的主题包括减肥手术后患者提到的咖啡因和烟草,以及内容专家提到的处方/非法药物。

对实践的启示

初级保健提供者进行有针对性的筛查,以早期识别问题行为,可能会导致心理健康提供者进行适当的转诊和管理,有助于减肥手术的持续成功。

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