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腹腔镜Roux-en-Y胃旁路术后3年,感知到的术后支持可区分反应者与无反应者。

Perceived Postoperative Support Differentiates Responders from Non-Responders 3 Years After Laparoscopic Roux-en-Y Gastric Bypass.

作者信息

Ter Braak Ulrike B J M, Hinnen Chris, de Jong Marjolein M C, van de Laar Arnold

机构信息

Department of Medical Psychology, ZGT Hospital, Hengelo, Netherlands.

Department of Medical Psychology and Hospital Psychiatry, MC Slotervaart, Amsterdam, Netherlands.

出版信息

Obes Surg. 2018 Feb;28(2):415-420. doi: 10.1007/s11695-017-2852-x.

Abstract

BACKGROUND

Bariatric surgery is an effective intervention for the majority of patients with morbid obesity, but a significant minority fails to achieve substantial weight loss. In the search of possible predictors of weight loss following bariatric surgery, preoperative factors turn out to have limited predictive power. This study will examine the impact of two postoperative factors on weight loss: perceived social support and stressful life events.

METHODS

From the entire 2013 cohort that underwent laparoscopic Roux-and-Y gastric bypass (LRYGB) in a general hospital in the Netherlands, a group of 56 non-responders and a matched group of 56 responders were selected, using an alterable weight loss (%AWL)-based percentile chart. Patients from both groups were interviewed by phone to collect data on demographics, medical complications and comorbidities, social support and stressful life events. A total of 61 patients completed the data collection (54% response rate).

RESULTS

One-way ANOVA analysis showed that responders and non-responders differed with regard to perceived support (F(1) = 8.60, p = .005). In a model with place of birth, level of education and pre-surgery diabetes mellitus as covariates, perceived social support was able to classify 83.6% of patients correctly as either responder or non-responder (χ  = 28.26, p < .001). Stressful life events turned out to be unrelated to weight loss.

CONCLUSIONS

Perceived social support differentiates responders from non-responders after LRYGB. When patients present themselves after LRYGB with sub-optimal weight loss, social support should be a focus of attention.

摘要

背景

减肥手术对大多数病态肥胖患者是一种有效的干预措施,但有相当一部分患者未能实现显著减重。在寻找减肥手术后体重减轻的可能预测因素时,术前因素的预测能力有限。本研究将探讨两个术后因素对体重减轻的影响:感知到的社会支持和应激性生活事件。

方法

从2013年在荷兰一家综合医院接受腹腔镜Roux-en-Y胃旁路术(LRYGB)的整个队列中,使用基于可改变体重减轻(%AWL)的百分位数图表,选取了一组56名无反应者和一组匹配的56名有反应者。通过电话采访两组患者,收集有关人口统计学、医疗并发症和合并症、社会支持和应激性生活事件的数据。共有61名患者完成了数据收集(回复率为54%)。

结果

单因素方差分析显示,有反应者和无反应者在感知到的支持方面存在差异(F(1)=8.60,p=.005)。在一个将出生地、教育程度和术前糖尿病作为协变量的模型中,感知到的社会支持能够正确地将83.6%的患者分类为有反应者或无反应者(χ=28.26,p<.001)。应激性生活事件与体重减轻无关。

结论

感知到的社会支持可区分LRYGB术后的有反应者和无反应者。当LRYGB术后患者体重减轻未达最佳时,社会支持应成为关注焦点。

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