Department of Surgery, Wisconsin Surgical Outcomes Research Program (WiSOR), University of Wisconsin-Madison, Madison, WI.
Collaborative Center for Health Equity, University of Wisconsin, Madison, WI.
Ann Surg. 2023 Apr 1;277(4):e745-e751. doi: 10.1097/SLA.0000000000005446. Epub 2022 Jul 6.
To characterize patient and provider perceptions of the impact of coronavirus disease 2019 (COVID-19) on weight loss following bariatric surgery.
COVID-19 has disrupted routines and healthcare throughout the United States, but its impact on bariatric surgery patients' postoperative experience is unknown.
Semistructured interviews with bariatric surgery patients, primary care providers, and health psychologists were conducted from April to November 2020. As part of a secondary analysis, patients and providers described how the COVID-19 pandemic affected the postoperative experience within 3 domains: dietary habits, physical activity, and follow-up care. Interview guides were created from 2 conceptual models: Torain's Surgical Disparities Model and Andersen's Behavioral Model of Health Services Use. Study team members derived codes, which were grouped into themes using conventional content analysis.
Thirty-four participants were interviewed: 24 patients (12 Roux-en-Y gastric bypass and 12 sleeve gastrectomy), 6 primary care providers, and 4 health psychologists. Patients were predominately female (83%) and White (79%). Providers were predominately female (90%) and White (100%). COVID-19 affected the postoperative bariatric surgery patient experience via 3 mechanisms: (1) it disrupted dietary and physical activity routines due to facility closures and fear of COVID-19 exposure; (2) it required patients to transition their follow-up care to telemedicine delivery; and (3) it increased stress due to financial and psychosocial challenges.
COVID-19 has exacerbated patient vulnerability. The pandemic is not over, thus bariatric surgery patients need ongoing support to access mental health professionals, develop new physical activity routines, and counteract increased food insecurity.
描述患者和医务人员对 2019 年冠状病毒病（COVID-19）对减肥手术（bariatric surgery）后体重减轻的影响的看法。
COVID-19 已经扰乱了美国各地的日常生活和医疗保健，但它对减肥手术患者术后体验的影响尚不清楚。
2020 年 4 月至 11 月，对减肥手术患者、初级保健提供者和心理健康专家进行了半结构化访谈。作为二次分析的一部分，患者和医务人员描述了 COVID-19 大流行如何在 3 个领域影响术后体验：饮食习惯、体力活动和后续护理。访谈指南是根据 2 个概念模型创建的：Torain 的手术差异模型和 Andersen 的卫生服务利用行为模型。研究团队成员提取了代码，然后使用常规内容分析将这些代码分组为主题。
共访谈了 34 名参与者：24 名患者（12 名 Roux-en-Y 胃旁路术和 12 名袖状胃切除术）、6 名初级保健提供者和 4 名心理健康专家。患者主要为女性（83%）和白人（79%）。提供者主要为女性（90%）和白人（100%）。COVID-19 通过 3 种机制影响减肥手术后的患者体验：（1）由于设施关闭和对 COVID-19 暴露的恐惧，打乱了饮食和体力活动常规；（2）需要患者将随访护理转为远程医疗服务；（3）由于财务和心理社会挑战，增加了压力。
COVID-19 加剧了患者的脆弱性。大流行尚未结束，因此减肥手术患者需要持续支持，以获得心理健康专业人员的帮助、发展新的体力活动常规，并应对增加的粮食不安全状况。
