Sunil Supreet, Santiago Vincent A, Gougeon Lorraine, Warwick Katie, Okrainec Allan, Hawa Raed, Sockalingam Sanjeev
Toronto Western Bariatric Surgery Program, University Health Network, University of Toronto, 399 Bathurst Street, Toronto, Ontario, M5T 2S8, Canada.
Department of Surgery, Toronto Western Hospital, University Health Network, University of Toronto, 399 Bathurst Street, Toronto, Ontario, M5T 2S8, Canada.
Obes Surg. 2017 Feb;27(2):416-423. doi: 10.1007/s11695-016-2306-x.
Vitamin supplementation in bariatric aftercare is essential to prevent nutrient deficiencies; however, rates of vitamin adherence have been as low as 30 % 6 months post-surgery. Preliminary literature suggests non-adherence to prescribed treatments can be linked to demographic and psychological factors. We aimed to determine the relationship between these factors to vitamin adherence in post-bariatric surgery patients.
A total of 92 bariatric patients were assessed 6 months post-surgery. Patients were administered a questionnaire collecting demographic information, psychological scores, and self-reported adherence. Nutrient deficiencies were analyzed through serum vitamin levels measured 3 and 6 months after surgery. Wilcoxon rank-sum and chi-square tests were used for analysis.
Non-adherence was associated with male sex and full-time employment (p = 0.027, p = 0.015). There were no differences with respect to living situation, education level, or relationship type. Non-adherent patients did not have significantly higher scores for generalized anxiety, depressive symptoms, or avoidant behaviors. However, non-adherent patients displayed greater attachment anxiety than their adherent counterparts (p = 0.0186). Non-adherence was also associated with lower vitamin B12 levels 6 months post-surgery (p = 0.001).
Male gender and full-time work have previously been shown to be associated with non-adherence. This is the first study to demonstrate that attachment anxiety is associated with poor multivitamin adherence in the post-surgical bariatric population. This result is concordant with recent literature that has demonstrated attachment anxiety is associated with poor adherence to dietary recommendations in bariatric patients 6 months postoperatively. Presurgical screening for attachment anxiety could facilitate early interventions to promote better bariatric aftercare in this group.
肥胖症术后的维生素补充对于预防营养缺乏至关重要；然而，术后6个月维生素依从率低至30%。初步文献表明，不遵守规定治疗可能与人口统计学和心理因素有关。我们旨在确定这些因素与肥胖症手术后患者维生素依从性之间的关系。
共对92例肥胖症患者术后6个月进行评估。向患者发放问卷，收集人口统计学信息、心理评分和自我报告的依从性。通过术后3个月和6个月测量的血清维生素水平分析营养缺乏情况。采用Wilcoxon秩和检验和卡方检验进行分析。
不依从与男性及全职工作有关（p = 0.027，p = 0.015）。在生活状况、教育水平或关系类型方面无差异。不依从患者在广泛性焦虑、抑郁症状或回避行为方面得分无显著更高。然而，不依从患者比依从患者表现出更大的依恋焦虑（p = 0.0186）。不依从还与术后6个月较低的维生素B12水平有关（p = 0.001）。
此前已表明男性和全职工作与不依从有关。这是第一项证明依恋焦虑与肥胖症手术后人群多种维生素依从性差有关的研究。这一结果与最近的文献一致，该文献表明依恋焦虑与肥胖症患者术后6个月饮食建议依从性差有关。术前筛查依恋焦虑可促进早期干预，以改善该群体的肥胖症术后护理。
