Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania.
Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania.
Surg Obes Relat Dis. 2021 Sep;17(9):1558-1565. doi: 10.1016/j.soard.2021.06.003. Epub 2021 Jun 21.
Bariatric surgery has been found to be effective in the treatment of severe obesity. Studies have shown that the majority of eligible patients do not undergo surgery.
It is important to identify variables that may impact patient decision making and potentially lead to the disproportionate underutilization of bariatric surgery.
The study was conducted at one academic medical center in central Pennsylvania.
Bariatric patients who participated in a preoperative psychological assessment from 2017 to early 2020 completed comprehensive self-report questionnaires addressing sociodemographic variables, health history, psychopathology, and eating behaviors. Body mass index was calculated based on clinical measurements of each patient at the start of the preoperative program. Sociodemographic variables and self-report instrument scores were compared between those who completed surgery and those who did not.
Of the 1234 participants, significant differences were found between the compared variables. All minority groups were less likely to undergo surgery than White patients. Participants reporting higher impairment were less likely to progress to surgery. Impairments across 3 behavioral eating assessments were associated with a lower likelihood of surgery.
There are multiple factors that contribute to patient progression to surgery, and ultimately whether the patient undergoes bariatric surgery. Results show a need for further investigation surrounding the sociodemographic and psychosocial variables that influence the patient's advancement to surgery. Both providers and patients could benefit from a deeper understanding of potential barriers to utilization of bariatric surgery.
减重手术已被证实对重度肥胖症的治疗有效。研究表明，大多数符合条件的患者并未接受手术。
确定可能影响患者决策并可能导致减重手术利用不足的变量非常重要。
该研究在宾夕法尼亚州中部的一家学术医疗中心进行。
2017 年至 2020 年初，参加术前心理评估的减重患者完成了全面的自我报告问卷，涵盖了社会人口统计学变量、健康史、精神病理学和饮食行为。体重指数根据每位患者在术前计划开始时的临床测量值计算。比较了完成手术和未完成手术的患者之间的社会人口统计学变量和自我报告量表评分。
在 1234 名参与者中，比较变量之间存在显著差异。所有少数群体接受手术的可能性均低于白人患者。报告有更高障碍的参与者不太可能进展到手术。3 项行为饮食评估中的障碍与手术可能性降低相关。
有多个因素会影响患者接受手术的进程，以及最终是否接受减重手术。结果表明，需要进一步研究影响患者接受手术的社会人口统计学和心理社会变量。了解利用减重手术的潜在障碍，既可以使提供者受益，也可以使患者受益。
