University of Texas Health Science Center at Houston, Dallas Campus, Dallas, Texas.
Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas.
Surg Obes Relat Dis. 2020 Jun;16(6):786-795. doi: 10.1016/j.soard.2020.01.031. Epub 2020 Feb 10.
Metabolic and bariatric surgery (MBS) is a safe and effective treatment choice for severe obesity. Yet only approximately 50% of those referred to MBS complete the procedure. Studies show that racial minority groups are less likely than non-Hispanic whites to complete MBS despite having higher rates of severe obesity and co-morbidities.
To conduct a qualitative study to determine facilitators and challenges to racially diverse patients completing MBS based on the 4 socioecological model domains (intrapersonal, interpersonal, organization/clinical interaction, and societal/environmental).
One university-based surgery practice serving a racially diverse patient population.
Focus groups and in-depth interviews were conducted (Spring 2019) among patients (n = 24, 70% female, 50% non-Hispanic black, 4% Hispanic) who completed MBS over the past year. Social support members were also included (n = 7). Grand tour questions were organized by the 4 socioecological model domains and within the context of MBS completion. Data were audio-recorded, transcribed, and coded. A thematic analysis combining a deductive and inductive approach was conducted. Codes were analyzed using Dedoose to identify themes/subthemes.
Ten themes and 15 subthemes were identified. Key intra- and interpersonal facilitators to MBS completion included social support systems, primary care physician support of MBS, co-morbidity resolution, discrimination experiences, and mobility improvements. Key community and environment themes associated with post-MBS sustained weight loss included community support groups and access to healthy foods and exercise facilities. No themes or subthemes varied by race.
Educating primary care physicians and social support networks about the benefits of MBS could improve utilization rates. MBS patients have a desire to have their communities provide resources to support their postoperative success.
代谢与减重手术（MBS）是治疗重度肥胖的安全有效方法。然而，只有大约 50%的患者完成了 MBS。研究表明，少数族裔患者完成 MBS 的比例低于非西班牙裔白人，尽管他们的重度肥胖和合并症发病率更高。
根据 4 个社会生态学模型领域（个体内、人际间、组织/临床互动和社会/环境），进行一项定性研究，以确定不同种族的患者完成 MBS 的促进因素和挑战。
一个为不同种族患者服务的大学附属手术实践。
对过去一年完成 MBS 的患者（n=24，70%为女性，50%为非西班牙裔黑人，4%为西班牙裔）和社会支持成员（n=7）进行焦点小组和深入访谈。Grand tour 问题按 4 个社会生态学模型领域组织，并结合 MBS 完成情况进行。数据进行音频记录、转录和编码。采用结合演绎和归纳方法的主题分析。使用 Dedoose 对代码进行分析，以确定主题/子主题。
确定了 10 个主题和 15 个子主题。MBS 完成的主要个体内和人际促进因素包括社会支持系统、初级保健医生对 MBS 的支持、合并症的解决、歧视经历和行动能力的改善。与 MBS 后持续体重减轻相关的主要社区和环境主题包括社区支持小组以及获得健康食品和锻炼设施的机会。种族之间没有出现主题或子主题的差异。
向初级保健医生和社会支持网络教育 MBS 的益处可以提高利用率。MBS 患者希望他们的社区提供资源来支持他们术后的成功。
