Kallies Kara J, Borgert Andrew J, Kothari Shanu N
Department of Medical Research, Gundersen Medical Foundation, La Crosse, WI, USA.
Department of General Surgery, Gundersen Health System, La Crosse, WI, USA.
Clin Obes. 2019 Apr;9(2):e12297. doi: 10.1111/cob.12297. Epub 2019 Feb 1.
As the rate of obesity continues to rise, primary care providers (PCPs) must be aware and informed of the treatment options available. Bariatric surgery is the most effective long-term treatment for weight loss and improvement of obesity-related comorbidities. The aim of this study was to assess patients' perception of their PCP's opinion, support and knowledge of bariatric surgery and changes over time. In 2009 and 2015, a 27-question survey was developed and mailed to patients who had undergone laparoscopic Roux-en-Y gastric bypass (LRYGB) at our institution. Statistical analysis included chi-square and Fisher's exact test for associations between categorical variables, Wilcoxon rank sum test for comparison of ordinal or continuous variables and sign test for comparison of paired ordinal variables. There were 680 and 1106 patients who met inclusion criteria and were mailed the 2009 and 2015 survey, respectively. The survey response rate was 47% in 2009 and 35% in 2015; 125 patients completed both surveys. In 2009 and 2015, 78% and 80% of patients described their PCP's opinion of bariatric surgery as "very supportive" (P = 0.64), and 29% and 40% described their PCP as "very knowledgeable" about bariatric surgery (P = 0.02), respectively. Post-operative support from PCPs was described as "very supportive" by 77% and 79% of patients in 2009 and 2015, respectively (P = 0.07). Overall, Ninety-seven percent of patients would repeat their LRYGB experience. The majority of patients perceived their PCP as being supportive of bariatric surgery. Physicians' knowledge of bariatric surgery could be improved by establishing more opportunities for education. While patients' perception of their PCP's knowledge increased, no significant improvements in PCP opinion or support of bariatric surgery were observed over time. Patients' willingness to repeat their experience with bariatric surgery remained high.
随着肥胖率持续上升，初级保健提供者（PCP）必须了解并知晓可用的治疗选择。减肥手术是减肥及改善肥胖相关合并症最有效的长期治疗方法。本研究的目的是评估患者对其初级保健提供者关于减肥手术的看法、支持及了解程度，以及随时间的变化情况。2009年和2015年，我们设计了一份包含27个问题的调查问卷，并邮寄给在我院接受腹腔镜Roux-en-Y胃旁路术（LRYGB）的患者。统计分析包括用于分类变量关联分析的卡方检验和Fisher精确检验、用于有序或连续变量比较的Wilcoxon秩和检验以及用于配对有序变量比较的符号检验。分别有680名和1106名符合纳入标准的患者收到了2009年和2015年的调查问卷。2009年的调查回复率为47%，2015年为35%；125名患者完成了两次调查。2009年和2015年，分别有78%和80%的患者将其初级保健提供者对减肥手术的看法描述为“非常支持”（P = 0.64），分别有29%和40%的患者将其初级保健提供者描述为对减肥手术“非常了解”（P = 0.02）。2009年和2015年，分别有77%和79%的患者将初级保健提供者术后的支持描述为“非常支持”（P = 0.07）。总体而言，97%的患者愿意再次接受LRYGB手术。大多数患者认为其初级保健提供者支持减肥手术。通过建立更多教育机会，可以提高医生对减肥手术的了解。虽然患者对其初级保健提供者知识水平的认知有所提高，但随着时间推移，未观察到初级保健提供者对减肥手术的看法或支持有显著改善。患者再次接受减肥手术的意愿仍然很高。
