Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.
, Rome, Italy.
Obes Surg. 2021 Sep;31(9):4045-4054. doi: 10.1007/s11695-021-05485-9. Epub 2021 Jul 2.
Bariatric surgery is an effective treatment for the obesity epidemic, but the poor attendance and adherence rates of post-surgery recommendations threaten treatment effectiveness and health outcomes. Preoperatively, we investigated the unique contributions of clinical (e.g., medical and psychiatric comorbidities), sociodemographic (e.g., sex, age, and educational level), and psychopathological variables (e.g., binge eating severity, the general level of psychopathological distress, and alexithymia traits) on differing dimensions of adherence in a group of patients seeking bariatric surgery.
The final sample consisted of 501 patients (346 women). All participants underwent a full psychiatric interview. Self-report questionnaires were used to assess psychopathology, binge eating severity, alexithymia, and three aspects of adherence: knowledge, attitude, and barriers to medical recommendations.
Attitude to adherence was associated with alexithymia (β = -2.228; p < 0.001) and binge eating disorder (β = 0.103; p = 0.047). The knowledge subscale was related to medical comorbidity (β = 0.113; p = 0.012) and alexithymia (β = -2.256; p < 0.001); with age (β = 0.161; p = 0.002) and psychiatric comorbidity (β =0.107; p = 0.021) manifesting in the barrier subscale.
We demonstrated that alexithymia and psychiatric and eating disorders impaired adherence reducing attitude and knowledge of treatment and increasing the barriers. Both patient and doctor can benefit from measuring adherence prior to surgery, with a qualitative approach shedding light on the status of adherence prior to the postsurgical phase when the damage regarding adherence is, already, done. Graphical Abstract.
减重手术是治疗肥胖症的有效方法，但术后建议的参与度和依从率低，威胁着治疗效果和健康结果。在术前，我们研究了临床因素（如医疗和精神共病）、社会人口学因素（如性别、年龄和教育水平）和心理病理变量（如暴食严重程度、一般心理病理困扰程度和述情障碍特征）对一组寻求减重手术患者不同维度的依从性的独特贡献。
最终样本包括 501 名患者（346 名女性）。所有参与者都接受了全面的精神科访谈。使用自我报告问卷评估心理病理、暴食严重程度、述情障碍以及对医疗建议的三个方面的依从性：知识、态度和障碍。
对依从性的态度与述情障碍（β = -2.228；p < 0.001）和暴食障碍（β = 0.103；p = 0.047）有关。知识量表与医疗共病（β = 0.113；p = 0.012）和述情障碍（β = -2.256；p < 0.001）有关；与年龄（β = 0.161；p = 0.002）和精神共病（β = 0.107；p = 0.021）有关表现在障碍量表上。
我们证明了述情障碍以及精神和饮食障碍会损害依从性，降低对治疗的态度和知识，增加障碍。在手术前测量依从性，患者和医生都可以从中受益，通过定性方法可以在术后阶段之前了解依从性的状况，因为此时已经对依从性造成了损害。
注意：这是一个基于医学研究的文本，专业术语较多，如果你对翻译结果有任何疑问或需要进一步解释，请随时向我提问。
