Shenandoah University, Exercise Science Department, Levi Perry, Shenandoah University, Division of Physical Therapy, Winchester, Virginia.
Shenandoah University, Division of Physical Therapy, Winchester, VA.
Surg Obes Relat Dis. 2018 Jan;14(1):39-45. doi: 10.1016/j.soard.2017.10.005. Epub 2017 Oct 12.
Literature on patient motivation for bariatric surgery remains limited. A few studies have examined relation to outcomes and found no established connection between motivation and weight loss.
A retrospective convenience sample of 345 participants was recruited from an obesity support website to complete an online survey.
Content analysis was used to describe motivations for surgery, and analysis of variance and covariance were completed to compare groups of participants created from the qualitative analysis on pre- and postsurgical factors like body mass index, number of co-morbidities, and percentage of excess weight loss.
A primary perceived affective response category for motivation was created that included 3 levels: desperate, tired, and pragmatic. Within these levels participants reported motivations related to quality of life, prevent death, last option, and trigger. Participants in the desperate level exhibited higher presurgical body mass index, greater number of presurgical co-morbidities, more attempted methods for weight loss, and more negative perceptions of health before surgery. Participants in the tired group experienced the greatest percentage of excess weight loss and participants in desperate and tired showed greater weight loss, percentage of weight lost, and percentage of excess weight lost compared with the pragmatic group when controlling for presurgical weight.
Most participants reported a physical health-related motivation, but participants with greater perceived affective motivational responses cited prevention of death and viewing surgery as their last option to a higher extent. Participants with greater perceived affective response exhibited significantly better weight loss outcomes, indicating that some emotional component to motivation may improve long-term success. Presurgical consultation might incorporate principles from the Transtheoretical Model and Motivational Interviewing to connect the emotional impacts of obesity on patients' health and well being to health behaviors promoting weight maintenance.
关于肥胖症患者接受减重手术的动机的文献仍然有限。有一些研究检查了与结果的关系，发现动机与体重减轻之间没有确定的联系。
有一些研究检查了与结果的关系，发现动机与体重减轻之间没有确定的联系。
从一个肥胖支持网站招募了 345 名参与者的回顾性便利样本，以完成在线调查。
使用内容分析法描述手术动机，并使用方差分析和协方差分析比较根据定性分析创建的术前和术后因素（如体重指数、合并症数量和超重减轻百分比）的参与者组。
创建了一个主要的感知情感反应类别，包括 3 个级别：绝望、疲倦和务实。在这些级别内，参与者报告了与生活质量、预防死亡、最后选择和触发相关的动机。绝望级别的参与者表现出更高的术前体重指数、更多的术前合并症、更多的减肥尝试方法以及对术前健康的更负面看法。疲倦组的参与者经历了最大比例的超重减轻，与务实组相比，绝望和疲倦组的参与者在控制术前体重时，体重减轻幅度、体重减轻百分比和超重减轻百分比更大。
大多数参与者报告了与身体健康相关的动机，但具有更大感知情感动机反应的参与者更有可能提到预防死亡和将手术视为他们的最后选择。具有更大感知情感反应的参与者表现出显著更好的减肥效果，这表明动机中的某些情感成分可能会提高长期成功的可能性。术前咨询可能会纳入跨理论模型和动机访谈的原则，将肥胖对患者健康和福祉的情感影响与促进体重维持的健康行为联系起来。
