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减重手术后体重反弹患者感知和偏好的社会支持:一项定性研究。

Perceived and Preferred Social Support in Patients Experiencing Weight Regain After Bariatric Surgery-a Qualitative Study.

机构信息

Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, SE-171 76, Stockholm, Sweden.

Center for Obesity, Academic Specialist Center, Stockholm, Sweden.

出版信息

Obes Surg. 2021 Mar;31(3):1256-1264. doi: 10.1007/s11695-020-05128-5. Epub 2020 Nov 17.

Abstract

PURPOSE

While bariatric surgery generally shows successful weight loss outcomes in patients with obesity, weight regain exists. The aim of this qualitative study was to improve understanding of how patients with substantial weight regain after bariatric surgery experienced the support from family, friends, and healthcare providers, and what kind of support they had preferred.

MATERIALS AND METHODS

Qualitative data were collected from semi-structured interviews with 16 participants. Mean weight regain from surgery to interview was 36%. The transcribed interviews were analyzed with thematic analysis.

RESULTS

Two main themes and seven sub-themes were formulated. The theme, A lonely struggle, illustrates patients' feelings of abandonment and struggle during weight regain due to lack of support or unfavorable treatment. Participants commonly blamed themselves for re-gaining weight, and shame made them reluctant to engage in social activities or seek medical care. The theme, Others as sources of compassion and control, covers what support they desired, as well as had perceived to be helpful. Exercising or eating healthy with others was appreciated and felt supportive. Pro-active healthcare support and access to dietitians, physiotherapists, and psychological support were desired.

CONCLUSION

To optimize the effect of bariatric surgery, support may need to be individualized and lifelong. Since shame and self-blame in patients with weight regain may hinder seeking professional help, care providers may need to initiate follow-up visits. Empathetic and non-judgmental support, access to multidisciplinary healthcare team, as well as peer-support groups may be beneficial to counteract weight regain post-bariatric surgery.

摘要

目的

尽管减重手术通常能使肥胖患者获得成功的减重效果,但仍存在体重反弹的情况。本定性研究旨在深入了解体重明显反弹的减重手术后患者从家人、朋友和医疗保健提供者处获得的支持,以及他们更倾向于获得何种支持。

材料和方法

从 16 名参与者的半结构式访谈中收集定性数据。手术至访谈时的平均体重反弹为 36%。对转录的访谈进行主题分析。

结果

制定了两个主要主题和七个子主题。主题为“孤独的挣扎”,说明了患者在因缺乏支持或不利治疗而导致体重反弹时感到被抛弃和挣扎的感受。参与者通常会自责体重反弹,羞耻感使他们不愿参与社交活动或寻求医疗护理。主题为“他人是同情和控制的源泉”,涵盖了他们期望得到的支持以及他们认为有帮助的支持。与他人一起锻炼或健康饮食受到赞赏,并感到支持。渴望获得积极主动的医疗保健支持以及营养师、物理治疗师和心理支持的机会。

结论

为了优化减重手术的效果,支持可能需要个体化和终身化。由于体重反弹患者的羞耻感和自责感可能会阻碍他们寻求专业帮助,因此护理提供者可能需要主动进行随访。富有同理心且不评判的支持、获得多学科医疗团队的机会以及同伴支持小组可能有助于对抗减重手术后的体重反弹。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc6d/7921025/10756564b837/11695_2020_5128_Fig1_HTML.jpg

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