从患者和提供者角度看减重手术的个体障碍：一项定性研究。
Individual-level barriers to bariatric surgery from patient and provider perspectives: A qualitative study.
机构信息
Department of Surgery, Wisconsin Surgical Outcomes Research Program (WiSOR), University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI, 53792, USA.
Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, 905 W Main St, Durham, NC, 27701, USA; Veterans Health Administration National Center for Health Promotion and Disease Prevention, 3022 Croasdaile Dr, Durham, NC, 27705, USA.
出版信息
Am J Surg. 2022 Jul;224(1 Pt B):429-436. doi: 10.1016/j.amjsurg.2021.12.022. Epub 2021 Dec 23.
BACKGROUND
Less than 1% adults in the United States who meet body mass index criteria undergo bariatric surgery. Our objective was to identify patient and provider perceptions of individual-level barriers to undergoing bariatric surgery.
METHODS
Adults with severe obesity and obesity care providers described their experiences with the bariatric surgery care process in semi-structured interviews. Using conventional content analysis, individual-level barriers were identified within Andersen's Behavioral Model of Health Services Use.
RESULTS
Of the 73 individuals interviewed, 36 (49%) were female, and 15 (21%) were non-white. Six individual-level barriers were identified: fear of surgery, fear of lifestyle change, perception that weight had not reached its "tipping point," concerns about dietary changes, lack of social support, and patient characteristics influencing referral.
CONCLUSIONS
Patient and provider education should address patient fears of surgery and the belief that surgery is a "last resort." Bariatric surgery programs should strengthen social support networks for patients.
背景
在美国，符合身体质量指数标准的成年人中，只有不到 1%接受了减重手术。我们的目的是确定患者和提供者对接受减重手术的个体障碍的看法。
方法
患有严重肥胖症的成年人和肥胖症护理提供者在半结构化访谈中描述了他们的减重手术护理过程的体验。使用传统的内容分析，在安德森健康服务使用行为模型中确定了个体层面的障碍。
结果
在接受采访的 73 人中，有 36 人（49%）为女性，15 人（21%）为非白人。确定了六个个体层面的障碍：对手术的恐惧、对生活方式改变的恐惧、认为体重尚未达到“临界点”、对饮食改变的担忧、缺乏社会支持以及影响转介的患者特征。
结论
患者和提供者的教育应解决患者对手术的恐惧和认为手术是“最后手段”的信念。减重手术项目应加强患者的社会支持网络。
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